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General NPI Number Information
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NPI Number | 1245587377
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Entity Type | Organization
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Legal Business Name | CLINICA DENTAL DOZ
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Dates
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Enumeration Date | 08/08/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 1075 CALLE MARGINAL VILLAMAR EXT. VILLAMAR ISLA VERDE
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City | CAROLINA
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State | PR
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Zip | 00979-6346
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Country | US
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Telephone | 787-727-3550
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Fax | 787-728-6855
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Provider Business Mailing Address
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Address Line | 1075 CALLE MARGINAL VILLAMAR EXT. VILLAMAR ISLA VERDE
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City | CAROLINA
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State | PR
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Zip | 00979-6346
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Country | US
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Telephone | 787-727-3550
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Fax | 787-728-6855
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. WANDA SUAREZ
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Credential |
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Telephone | 787-727-3550
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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 |
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License Number State |
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