Healthcare Provider Details
I. General information
NPI: 1316882764
Provider Name (Legal Business Name): MARRERO-SANTIAGO GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 CALLE PRINCIPAL
MOROVIS PR
00687-3322
US
IV. Provider business mailing address
PO BOX 109
MOROVIS PR
00687-0109
US
V. Phone/Fax
- Phone: 787-862-4615
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LOREINY
MARRERO COLON
Title or Position: PRESIDENTE
Credential:
Phone: 939-254-7909