Healthcare Provider Details

I. General information

NPI: 1386585842
Provider Name (Legal Business Name): DR DS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AVE SAN PATRICIO STE 820
GUAYNABO PR
00968-2678
US

IV. Provider business mailing address

101 AVE SAN PATRICIO STE 820
GUAYNABO PR
00968-2678
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-9341
  • Fax:
Mailing address:
  • Phone: 787-641-9341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DAMIL VAZQUEZ
Title or Position: DMD
Credential: DMD
Phone: 787-641-9341