Provider Demographics
NPI:1861403966
Name:CANTO, ROSA ELENA
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:ELENA
Last Name:CANTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 36 BOX 1363
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9704
Mailing Address - Country:US
Mailing Address - Phone:787-761-0892
Mailing Address - Fax:787-760-7056
Practice Address - Street 1:2363 AVE LAS AMERICAS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0776
Practice Address - Country:US
Practice Address - Phone:787-284-0000
Practice Address - Fax:787-841-0943
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics