Provider Demographics
NPI:1447459300
Name:TALAVERA, CESAR RAMON
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:RAMON
Last Name:TALAVERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 7268
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-7335
Mailing Address - Country:US
Mailing Address - Phone:787-403-4385
Mailing Address - Fax:
Practice Address - Street 1:CARR. 493, KM 0.9, BO CARRIZALES
Practice Address - Street 2:DEL NORTE PROFFESIONAL CENTER
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-403-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27181223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery