| Patricio J. Sumaza, Dmd, Csp | |
|
351 Ave Hostos Suite 211, Medical Emporium Mayaguez PR 00680-1502 | |
| (787) 986-3636 | |
| (787) 805-1610 |
| Full Name | Patricio J. Sumaza, Dmd, Csp |
|---|---|
| Speciality | Dentist |
| Location | 351 Ave Hostos, Mayaguez, Puerto Rico |
| Authorized Official Name and Position | Patricio Javier Sumaza (PRESIDENTE) |
| Authorized Official Contact | 7879863636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patricio J. Sumaza, Dmd, Csp 351 Ave Hostos Suite 211, Medical Emporium Mayaguez PR 00680-1502 Ph: (787) 986-3636 | Patricio J. Sumaza, Dmd, Csp 351 Ave Hostos Suite 211, Medical Emporium Mayaguez PR 00680-1502 Ph: (787) 986-3636 |
| NPI Number | 1295732147 |
|---|---|
| Provider Enumeration Date | 07/07/2005 |
| Last Update Date | 06/28/2012 |
| Medicare PECOS PAC ID | 7719139500 |
|---|---|
| Medicare Enrollment ID | O20121129000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295732147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 2496 (Puerto Rico) | Primary |
| Provider Name | Patricio J Sumaza |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1457356180 PECOS PAC ID: 8527210319 Enrollment ID: I20121129000556 |
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