Provider Demographics
NPI:1487708509
Name:BONET RODRIGUEZ, RAUL (DMD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:BONET RODRIGUEZ
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 1:683 CALLE ACUARIO
Mailing Address - Street 2:URB. VENUS GARDENS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4814
Mailing Address - Country:US
Mailing Address - Phone:787-760-5165
Mailing Address - Fax:787-748-2910
Practice Address - Street 1:683 CALLE ACUARIO
Practice Address - Street 2:URB. VENUS GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4814
Practice Address - Country:US
Practice Address - Phone:787-760-5165
Practice Address - Fax:787-748-2910
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice