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General NPI Number Information
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NPI Number | 1083808455
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Entity Type | Organization
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Legal Business Name | VKT DENTAL
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | CALLE BARBOSA #5 SUITE #1
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 787-872-2046
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2119
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City | ISABELA
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State | PR
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Zip | 00662-2001
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Country | US
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Telephone | 787-872-2046
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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. THANYAH ISOBEL PEREZ
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Credential | DMD
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Telephone | 787-872-2046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2493
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License Number State | PR
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