Provider Demographics
NPI:1134168156
Name:SANTOS, EUGENIA (DMD)
Entity type:Individual
Prefix:DR
First Name:EUGENIA
Middle Name:
Last Name:SANTOS
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:D19 CALLE 3
Mailing Address - Street 2:URB HILLSIDE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5241
Mailing Address - Country:US
Mailing Address - Phone:787-789-9216
Mailing Address - Fax:787-789-9216
Practice Address - Street 1:D19 CALLE 3
Practice Address - Street 2:URB HILLSIDE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5241
Practice Address - Country:US
Practice Address - Phone:787-789-9216
Practice Address - Fax:787-789-9216
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR06601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice