| Centro De Microendodoncia De Puerto Rico | |
|
500 Ave Degetau Hima Plaza I Suite 313 Caguas PR 00725-7301 | |
| (787) 653-6210 | |
| (787) 653-5846 |
| Full Name | Centro De Microendodoncia De Puerto Rico |
|---|---|
| Speciality | Dentist |
| Location | 500 Ave Degetau, Caguas, Puerto Rico |
| Authorized Official Name and Position | Dannelly B Gonzalez (ENDODONTIST) |
| Authorized Official Contact | 7876888389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro De Microendodoncia De Puerto Rico 500 Ave Degetau Hima Plaza I Suite 313 Caguas PR 00725-7301 Ph: (787) 653-6210 | Centro De Microendodoncia De Puerto Rico 500 Ave Degetau Hima Plaza I Suite 313 Caguas PR 00725-7301 Ph: (787) 653-6210 |
| NPI Number | 1376918714 |
|---|---|
| Provider Enumeration Date | 12/10/2015 |
| Last Update Date | 06/10/2022 |
| Medicare PECOS PAC ID | 4385904556 |
|---|---|
| Medicare Enrollment ID | O20180207002681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376918714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
| Provider Name | Dannelly B. Gonzalez |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508190943 PECOS PAC ID: 7618120643 Enrollment ID: I20121226000354 |
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