Provider Demographics
NPI:1871615625
Name:MARQUES SAAVEDRA, MARIA ELENA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ELENA
Last Name:MARQUES SAAVEDRA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CALLE CUEVILLAS
Mailing Address - Street 2:3B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2534
Mailing Address - Country:US
Mailing Address - Phone:787-356-9111
Mailing Address - Fax:
Practice Address - Street 1:AVE APOLO A-2
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-272-0152
Practice Address - Fax:787-272-0150
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR041989OtherLA CRUZ AZUL OF PR
PR206979OtherPREFEERED HEALTH
PA0552OtherINT MEDICAL CARD
PR42387OtherTRIPLE S