Provider Demographics
NPI:1972721470
Name:GONZALEZ-ROMAN, YOLANDA (DMD)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:
Last Name:GONZALEZ-ROMAN
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:ALTURAS DE TORRIMAR ESTE
Mailing Address - Street 2:24 CALLE 1
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-723-7844
Mailing Address - Fax:
Practice Address - Street 1:FIRST FEDERAL BLDG.
Practice Address - Street 2:SUITE 303
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-723-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14241223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR41494GOOtherTRIPLE S PROVIDER ID
PR1424OtherDMD LICENSE