Healthcare Provider Details

I. General information

NPI: 1497587620
Provider Name (Legal Business Name): CARRION ENDODONTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA REAL SHOPPING CENTER AVE. ALBOLOTE #1 SUITE 105
GUAYNABO PR
00969
US

IV. Provider business mailing address

630 AVE SAN PATRICIO APT 205
GUAYNABO PR
00968-4511
US

V. Phone/Fax

Practice location:
  • Phone: 787-400-9714
  • Fax:
Mailing address:
  • Phone: 787-233-7508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: YINA I. CARRION ABREU
Title or Position: PRESIDENTE
Credential: DMD
Phone: 787-233-7508