Healthcare Provider Details
I. General information
NPI: 1215923883
Provider Name (Legal Business Name): HECTOR LUIS JOY D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 09/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
I24 CALLE 3 URB. FLAMBOYAN
MANATI PR
00674-5438
US
IV. Provider business mailing address
PO BOX 982
MANATI PR
00674-0982
US
V. Phone/Fax
- Phone: 787-884-5542
- Fax: 787-884-7189
- Phone: 787-884-5542
- Fax: 787-884-7189
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | 1401 |
| License Number State | PR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: