| Licdentalandmedicalcsp | |
|
Palmer/hernaiz Ave St #74 Ste 2 Canovanas PR 00729-1617 | |
| (787) 256-3115 | |
| Not Available |
| Full Name | Licdentalandmedicalcsp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | Palmer/hernaiz Ave St #74, Canovanas, Puerto Rico |
| Authorized Official Name and Position | Luis Iturrino (PRESIDENT) |
| Authorized Official Contact | 7872563115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Licdentalandmedicalcsp Po Box 1617 Canovanas Canovanas PR 00729-1617 Ph: (787) 256-3115 | Licdentalandmedicalcsp Palmer/hernaiz Ave St #74 Ste 2 Canovanas PR 00729-1617 Ph: (787) 256-3115 |
| NPI Number | 1164706297 |
|---|---|
| Provider Enumeration Date | 10/07/2011 |
| Last Update Date | 10/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164706297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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