Provider Demographics
NPI:1437033115
Name:ALVAREZ, LETICIA G (DDS)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:G
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-4372
Mailing Address - Country:US
Mailing Address - Phone:928-509-1279
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA MADERO Y CALLE 15
Practice Address - Street 2:
Practice Address - City:SAN LUIS RIO COLORADO
Practice Address - State:SONORA
Practice Address - Zip Code:83448
Practice Address - Country:MX
Practice Address - Phone:928-509-1279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ3682991122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist