Provider Demographics
NPI:1306047311
Name:SOSA, FERNANDO ARTURO (DMD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:ARTURO
Last Name:SOSA
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:PO BOX 7891
Mailing Address - Street 2:PMB 281
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7891
Mailing Address - Country:US
Mailing Address - Phone:787-786-8205
Mailing Address - Fax:
Practice Address - Street 1:51-47 AVE MAIN
Practice Address - Street 2:URB. SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6636
Practice Address - Country:US
Practice Address - Phone:787-786-8205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics