Healthcare Provider Details

I. General information

NPI: 1013872241
Provider Name (Legal Business Name): RENOVA DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUITE 122 2DO PISO CARR 493 KM 0.5 CARRIZALES
HATILLO PR
00659-0000
US

IV. Provider business mailing address

8831 A CARR. 484
QUEBRADILLA PR
00678-9740
US

V. Phone/Fax

Practice location:
  • Phone: 787-223-2297
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. JAVIER ALBERTO CRUZ SAAVEDRA
Title or Position: PRESIDENTE
Credential: DMD
Phone: 787-223-2297