Provider Demographics
NPI:1063556207
Name:NAIM, WADIH (DMD)
Entity type:Individual
Prefix:DR
First Name:WADIH
Middle Name:
Last Name:NAIM
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 1:45 CALLE CALISTEMON
Mailing Address - Street 2:ESTANCIAS DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3166
Mailing Address - Country:US
Mailing Address - Phone:787-783-1674
Mailing Address - Fax:
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:LA TORRE DE PLAZA STE 706
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-753-3605
Practice Address - Fax:787-753-3605
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18341223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics