Provider Demographics
NPI:1215944707
Name:SILVA-BONAR, JOSE M (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:M
Last Name:SILVA-BONAR
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:BARCELO ST.
Mailing Address - Street 2:#12
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-0000
Mailing Address - Country:US
Mailing Address - Phone:787-870-4357
Mailing Address - Fax:787-790-7113
Practice Address - Street 1:BARCELO ST.
Practice Address - Street 2:#12
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-0000
Practice Address - Country:US
Practice Address - Phone:787-870-4357
Practice Address - Fax:787-790-7113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice