Healthcare Provider Details

I. General information

NPI: 1942287594
Provider Name (Legal Business Name): RAUL SANCHEZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 CALLE LOS MIRTOS HYDE PARK
SAN JUAN PR
00927-4235
US

IV. Provider business mailing address

PO BOX 363046
SAN JUAN PR
00936-3046
US

V. Phone/Fax

Practice location:
  • Phone: 787-765-0000
  • Fax: 787-764-1815
Mailing address:
  • Phone: 787-765-0000
  • Fax: 787-764-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number510
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: