Healthcare Provider Details

I. General information

NPI: 1205728920
Provider Name (Legal Business Name): RESTORE SKIN AND SMILE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CALLE COMERCIO
RINCON PR
00677-2201
US

IV. Provider business mailing address

213 HACIENDA LA MONSERRATE CALLE GORRION C5
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 939-407-1374
  • Fax:
Mailing address:
  • Phone: 787-600-6806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. MONICA MARIE RODRIGUEZ MONROIG
Title or Position: DENTIST/PRESIDENT
Credential: DMD
Phone: 939-407-1374