Healthcare Provider Details

I. General information

NPI: 1346416831
Provider Name (Legal Business Name): OFICINA DENTAL DRA. GINA THOMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB MUNOZ RIVERA 5 CALLE ACERINA
GUAYNABO PR
00969
US

IV. Provider business mailing address

URB MUNOZ RIVERA 5 CALLE ACERINA
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-4267
  • Fax: 787-720-7717
Mailing address:
  • Phone: 787-720-4267
  • Fax: 787-720-7717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. GINA THOMAS
Title or Position: DENTIST / OWNER
Credential: DMD.
Phone: 787-720-4267