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General NPI Number Information
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NPI Number | 1164007514
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Entity Type | Organization
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Legal Business Name | DENTISTAS ASOCIADOS DE PUERTO RICO
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Dates
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Enumeration Date | 03/16/2021
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 17 CALLE FELIX TIO
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City | SABANA GRANDE
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State | PR
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Zip | 00637
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Country | US
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Telephone | 787-832-8835
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Fax |
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Provider Business Mailing Address
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Address Line | EDIF DR CENTER SUITE 201 27 NELSON PEREA
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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 | 787-832-8835
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARVIN ALAMEDA
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Credential | DMD, MPH
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Telephone | 787-832-8835
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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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