Provider Demographics
NPI:1194067827
Name:DELIZ-GUZMAN, REINALDO E (DMD)
Entity type:Individual
Prefix:DR
First Name:REINALDO
Middle Name:E
Last Name:DELIZ-GUZMAN
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 1:1900 AVE. JESUS T. PINEIRO, SUITE 5
Mailing Address - Street 2:MARGINAL EXPRESO MARTINEZ NADAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:787-402-3746
Mailing Address - Fax:
Practice Address - Street 1:1900 AVE. JESUS T. PINEIRO, SUITE 5
Practice Address - Street 2:MARGINAL EXPRESO MARTINEZ NADAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-402-3746
Practice Address - Fax:787-834-3006
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR31931223G0001X, 1223P0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program