| Champion Dental Pc | |
|
Carretera 693 Km 13.7 Plaza Del Mar Sopping C Suite 201b Vega Alta PR 00646 | |
| (787) 369-7600 | |
| Not Available |
| Full Name | Champion Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | Carretera 693 Km 13.7, Vega Alta, Puerto Rico |
| Authorized Official Name and Position | Derrick Champion (DENTIST/OWNER) |
| Authorized Official Contact | 7873697600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Champion Dental Pc 207 Calle Metis Dorado PR 00646-4618 Ph: (787) 369-7600 | Champion Dental Pc Carretera 693 Km 13.7 Plaza Del Mar Sopping C Suite 201b Vega Alta PR 00646 Ph: (787) 369-7600 |
| NPI Number | 1366809725 |
|---|---|
| Provider Enumeration Date | 01/15/2016 |
| Last Update Date | 01/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366809725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3179 (Puerto Rico) | Primary |
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