Provider Demographics
NPI:1962932244
Name:CALDERO QUINONES, YADIEL (DMD)
Entity type:Individual
Prefix:
First Name:YADIEL
Middle Name:
Last Name:CALDERO QUINONES
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:HC 6 BOX 12571
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-7845
Mailing Address - Country:US
Mailing Address - Phone:787-448-8807
Mailing Address - Fax:
Practice Address - Street 1:CARR. 152 KM 11.7
Practice Address - Street 2:BO. CEDRO ARRIBA
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-7335
Practice Address - Fax:787-276-2205
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3267122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist