Provider Demographics
NPI:1912243635
Name:ARENAS, AGNES VANESSA (DMD)
Entity type:Individual
Prefix:DR
First Name:AGNES
Middle Name:VANESSA
Last Name:ARENAS
Suffix:
Gender:F
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:R19 CALLE 24
Mailing Address - Street 2:VILLA UNIVERSITARIA
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-4345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:R19 CALLE 24
Practice Address - Street 2:VILLA UNIVERSITARIA
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4345
Practice Address - Country:US
Practice Address - Phone:787-852-5785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist