Provider Demographics
NPI:1366440208
Name:CALERO, ISAAC RAMON SR (DMD)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:RAMON
Last Name:CALERO
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ISAAC
Other - Middle Name:RAMON
Other - Last Name:CALERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:B2 CALLE TURQUESA
Mailing Address - Street 2:URBANIZACION LAMELA
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2369
Mailing Address - Country:US
Mailing Address - Phone:787-872-3492
Mailing Address - Fax:787-872-7840
Practice Address - Street 1:108 CALLE ROMAN
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2928
Practice Address - Country:US
Practice Address - Phone:787-872-7840
Practice Address - Fax:787-872-7840
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2629122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
42089OtherSSS
6620067OtherHUMANA
206772OtherPRIVATE PLANS/P. HEALTH
100034OtherCA
P089OtherIMC