Provider Demographics
NPI:1104886027
Name:RIBOT, NYDIA
Entity type:Individual
Prefix:DR
First Name:NYDIA
Middle Name:
Last Name:RIBOT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1245
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-863-9424
Mailing Address - Fax:787-801-0859
Practice Address - Street 1:CALLE DIEGO ZALDUONDE
Practice Address - Street 2:#316 VEVE
Practice Address - City:FAJARGO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-863-9424
Practice Address - Fax:787-801-0859
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice