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General NPI Number Information
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NPI Number | 1154294759
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Entity Type | Organization
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Legal Business Name | IA DENTAL LLC
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 45 AVE ESMERALDA URB . MUNOZ RIVERA
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City | GUAYNABO
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State | PR
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Zip | 00969-4429
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Country | US
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Telephone | 787-720-2125
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Fax |
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Provider Business Mailing Address
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Address Line | 45 AVE ESMERALDA
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City | GUAYNABO
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State | PR
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Zip | 00969-4429
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Country | US
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Telephone | 787-720-2125
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. INGRID IRIZARRY PEREZ
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Credential |
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Telephone | 787-720-2125
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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 |
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License Number State |
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