Healthcare Provider Details

I. General information

NPI: 1447301098
Provider Name (Legal Business Name): PATRICIA ROVIRA VECCHINI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 AVE LA CEIBA ROVIRA OFFICE PARK, SUITE 101
PONCE PR
00717-1902
US

IV. Provider business mailing address

623 AVE LA CEIBA ROVIRA OFFICE PARK, SUITE 101
PONCE PR
00717-1902
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-7500
  • Fax: 787-844-7880
Mailing address:
  • Phone: 787-844-7500
  • Fax: 787-844-7880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2111
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: