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General NPI Number Information
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NPI Number | 1104492594
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Entity Type | Individual
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Provider Name | DR. GUILLERMO JOSE BERRIOS GARCIA
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Gender | Male
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | INTERSECCION 696 CALLE FELICITA RINCON DE GAUTIER B.O. HIGUILLAR
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 939-246-4990
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Fax |
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Provider Business Mailing Address
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Address Line | HC 3 BOX 6611
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City | HUMACAO
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State | PR
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Zip | 00791-9520
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Country | US
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Telephone | 939-246-4990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3396
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License Number State | PR
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