Healthcare Provider Details

I. General information

NPI: 1821890211
Provider Name (Legal Business Name): ANDREA MARIA CAPO DOSAL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COND RIBERAS DEL RIO # 6G17
BAYAMON PR
00959-8899
US

IV. Provider business mailing address

COND RIBERAS DEL RIO # 6G17
BAYAMON PR
00959-8899
US

V. Phone/Fax

Practice location:
  • Phone: 787-457-7464
  • Fax:
Mailing address:
  • Phone: 787-457-7464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3609
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: