Healthcare Provider Details

I. General information

NPI: 1568256378
Provider Name (Legal Business Name): PR ENDODONTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 BALSEIRO URB DUHAMEL
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 213
ISABELA PR
00662-0213
US

V. Phone/Fax

Practice location:
  • Phone: 787-456-1016
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PEDRO M RAMOS MUNOZ
Title or Position: OWNER
Credential:
Phone: 787-456-1016