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NPI Code Detail

MEDICARE: C L A DENTAL GROUP

MEDICARE: C L A DENTAL GROUP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodontics1318PR
21223G0001XGeneral Practice Dentistry1586PR
31223G0001XGeneral Practice Dentistry2772PR
41223G0001XGeneral Practice Dentistry2716PR
51223G0001XGeneral Practice Dentistry2101PR
61223P0221XPediatric Dentistry2239PR
71223P0300XPeriodontics0626PR
81223P0300XPeriodontics2444PR
91223X0400XOrthodontics and Dentofacial Orthopedics Dentistry1787PR
101223X0400XOrthodontics and Dentofacial Orthopedics Dentistry0266PR
111223X0400XOrthodontics and Dentofacial Orthopedics Dentistry2454PR
121223G0001XGeneral Practice Dentistry1804PR

General Provider Information

NPI Number : 1346362928
Entity Type Code : Organization
Provider Name (Legal Business Name) : C L A DENTAL GROUP
Provider Business Mailing Address
First Line : 735 AVE PONCE DE LEON STE 504
Second Line :
City : SAN JUAN
State : PR
Zip : 00917-5026
Country : US
Telephone Number : 787-753-5055
Fax Number :
Provider Business Practice Location Address
First Line : 735 AVE PONCE DE LEON STE 504
Second Line :
City : SAN JUAN
State : PR
Zip : 00917-5026
Country : US
Telephone Number : 787-753-5055
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. CARLOS H. MARTINEZ
Credential : DDS
Telephone Number : 787-753-5055
Provider Enumeration Date : 04/04/2007
Last Update Date : 09/11/2025

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Directions to “C L A DENTAL GROUP ” Practice Location

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