Healthcare Provider Details

I. General information

NPI: 1952128084
Provider Name (Legal Business Name): ARC DENTAL PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 03/31/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO ROCHELAISE CENTER WESTERN INDUSTRIAL PARK STE 301
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

EDIFICIO ROCHELAISE CENTER WESTERN INDUSTRIAL PARK SUITE 301
MAYAGUEZ PR
00680-1358
US

V. Phone/Fax

Practice location:
  • Phone: 787-299-1558
  • Fax:
Mailing address:
  • Phone: 787-313-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ASHLEY MICHELLE ROSARIO CRUZ
Title or Position: PRESIDENT
Credential: DMD
Phone: 787-313-0440