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General NPI Number Information
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NPI Number | 1083437172
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Entity Type | Organization
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Legal Business Name | IN PROSTHODONTICS LLC
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 351 AVE HOSTOS STE 214
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City | MAYAGUEZ
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State | PR
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Zip | 00680-1503
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Country | US
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Telephone | 787-806-2442
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Fax |
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Provider Business Mailing Address
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Address Line | URB. SULTANA 65 MALAGA ST.
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-447-6944
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDRES NEFTALI IRIZARRY NAZARIO
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Credential | DMD, MS
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Telephone | 787-447-6944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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