Provider Demographics
NPI:1578293601
Name:MORALES-OLIVER, CHRISTIAN GABRIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:GABRIEL
Last Name:MORALES-OLIVER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 AVE SAGRADO CORAZON APT 6B
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00915-3322
Mailing Address - Country:US
Mailing Address - Phone:787-363-0334
Mailing Address - Fax:
Practice Address - Street 1:551 AVE ESCORIAL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4706
Practice Address - Country:US
Practice Address - Phone:787-782-0403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR35211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program