Provider Demographics
NPI:1104941327
Name:MORALES, YANIRA LOAIZA (DMD)
Entity type:Individual
Prefix:MRS
First Name:YANIRA
Middle Name:LOAIZA
Last Name:MORALES
Suffix:
Gender:F
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:CONDOMINIO PASEOMONTE APTO 1408
Mailing Address - Street 2:AVE FELISA RINCON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-479-3424
Mailing Address - Fax:
Practice Address - Street 1:AVE AL COMANDANTE HR 17 COUNTRY CLUB
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982
Practice Address - Country:US
Practice Address - Phone:787-276-2155
Practice Address - Fax:787-276-2155
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2429122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist