| Cavity Repair Llc | |
|
Palmas Plantation 122 Humacao PR 00791-6022 | |
| (787) 515-7036 | |
| (787) 885-0560 |
| Full Name | Cavity Repair Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | Palmas Plantation, Humacao, Puerto Rico |
| Authorized Official Name and Position | Edwin E Lafontaine (DENTIST) |
| Authorized Official Contact | 7875157036 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cavity Repair Llc 122 Palmas Plantation Tee Street Humacao PR 00791-6022 Ph: (787) 515-7136 | Cavity Repair Llc Palmas Plantation 122 Humacao PR 00791-6022 Ph: (787) 515-7036 |
| NPI Number | 1487011128 |
|---|---|
| Provider Enumeration Date | 01/26/2016 |
| Last Update Date | 01/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487011128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2080 (Puerto Rico) | Primary |
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