Healthcare Provider Details

I. General information

NPI: 1770403107
Provider Name (Legal Business Name): NOR DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92-3 CALLE 78
BAYAMON PR
00961-4406
US

IV. Provider business mailing address

92-3 CALLE 78
BAYAMON PR
00961-4406
US

V. Phone/Fax

Practice location:
  • Phone: 939-336-2363
  • Fax: 939-336-2363
Mailing address:
  • Phone: 939-336-2363
  • Fax: 939-336-2363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: JUAN ANTONIO CABAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-649-7458