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General NPI Number Information
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NPI Number | 1033551445
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Entity Type | Organization
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Legal Business Name | SAN FRANCISCO DENTAL, LLC
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 07/26/2013
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Provider Practice Location Address
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Address Line | 87 AVE DE DIEGO SUITE 223
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City | SAN JUAN
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State | PR
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Zip | 00927-6322
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Country | US
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Telephone | 787-767-1015
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Fax |
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Provider Business Mailing Address
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Address Line | 87 AVE DE DIEGO SUITE 223
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City | SAN JUAN
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State | PR
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Zip | 00927-6322
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Country | US
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Telephone | 787-767-1015
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NANETTE R MENDEZ
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Credential | DMD
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Telephone | 787-505-2662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2698
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License Number State | PR
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