Provider Demographics
NPI:1285798900
Name:ALVARADO, JOSE R (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:ALVARADO
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:BE11 CALLE 101
Mailing Address - Street 2:JARDINES COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-2009
Mailing Address - Country:US
Mailing Address - Phone:787-752-4070
Mailing Address - Fax:787-752-7890
Practice Address - Street 1:BE11 CALLE 101
Practice Address - Street 2:JARDINES COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-2009
Practice Address - Country:US
Practice Address - Phone:787-752-4070
Practice Address - Fax:787-752-7890
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR06891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice