Provider Demographics
NPI:1295872406
Name:BOADA, LIANA I (DMD)
Entity type:Individual
Prefix:DR
First Name:LIANA
Middle Name:I
Last Name:BOADA
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 1:239 AVE ARTERIAL HOSTOS
Mailing Address - Street 2:SUITE 1103
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1477
Mailing Address - Country:US
Mailing Address - Phone:787-754-7747
Mailing Address - Fax:787-754-7747
Practice Address - Street 1:239 AVE ARTERIAL HOSTOS
Practice Address - Street 2:SUITE 1103
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1477
Practice Address - Country:US
Practice Address - Phone:787-754-7747
Practice Address - Fax:787-754-7747
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1045122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist