Healthcare Provider Details

I. General information

NPI: 1821176215
Provider Name (Legal Business Name): JORGE FIGUEROA D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

K1 CALLE 1 VALPARAISO
TOA BAJA PR
00949-4004
US

IV. Provider business mailing address

K1 CALLE 1 VALPARAISO
TOA BAJA PR
00949-4004
US

V. Phone/Fax

Practice location:
  • Phone: 787-869-1115
  • Fax: 787-869-1115
Mailing address:
  • Phone: 787-869-1115
  • Fax: 787-869-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number991
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: