Provider Demographics
NPI:1871544908
Name:CESTERO ALVAREZ, ANGEL RAFAEL (DMD)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:RAFAEL
Last Name:CESTERO ALVAREZ
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:RIO MARAVILLA A N-4
Mailing Address - Street 2:VALLE VERDE
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-795-3614
Mailing Address - Fax:
Practice Address - Street 1:AMALIA PAOLI AVE # HP-16
Practice Address - Street 2:LEVITOWN 7TH SEC
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-784-0282
Practice Address - Fax:787-784-5560
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR908122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
41093CEOtherSSS BLUE SHIELD
40655OtherBLUE CROSS