Provider Demographics
NPI:1104876515
Name:CALDERON, DAGNES Y (MD)
Entity type:Individual
Prefix:
First Name:DAGNES
Middle Name:Y
Last Name:CALDERON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G15 CALLE 8
Mailing Address - Street 2:EL MIRADOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7576
Mailing Address - Country:US
Mailing Address - Phone:787-761-5718
Mailing Address - Fax:787-721-5388
Practice Address - Street 1:G15 CALLE 8
Practice Address - Street 2:EL MIRADOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7576
Practice Address - Country:US
Practice Address - Phone:787-761-5718
Practice Address - Fax:787-721-5388
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13371223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry