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General NPI Number Information
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NPI Number | 1053099861
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Entity Type | Organization
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Legal Business Name | TOA ALTA DENTAL INSTITUTED LLC
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | RIO DEL PLATA MALL CARR 165 ESQ CALLE 1
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City | TOA ALTA
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State | PR
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Zip | 00953
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Country | US
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Telephone | 787-513-1132
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Fax |
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Provider Business Mailing Address
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Address Line | 1353 LUIS VIGOREAUX PMB 223
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-513-1132
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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. JOSE FRANCISCO CASTILLO
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Credential | DMD
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Telephone | 787-513-1132
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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 |
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License Number State |
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