Provider Demographics
NPI:1053378992
Name:ARROYO-ORTIZ, MAYRA (DMD)
Entity type:Individual
Prefix:MRS
First Name:MAYRA
Middle Name:
Last Name:ARROYO-ORTIZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OB8 CALLE 502
Mailing Address - Street 2:4TH EXT. COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-1816
Mailing Address - Country:US
Mailing Address - Phone:787-769-7582
Mailing Address - Fax:
Practice Address - Street 1:165 CALLE BALDORIOTY N
Practice Address - Street 2:OFFICE #13
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3234
Practice Address - Country:US
Practice Address - Phone:787-735-2177
Practice Address - Fax:787-735-1741
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice