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General NPI Number Information
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NPI Number | 1285766105
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Entity Type | Organization
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Legal Business Name | LAS AMERICAS DENTAL CENTER, INC
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | PLAZOLETA LAS AMERICAS 2015 AVE LAS AMERICAS SUITE 101
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City | PONCE
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State | PR
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Zip | 00717-0784
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Country | US
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Telephone | 787-259-5151
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Fax | 787-290-4472
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Provider Business Mailing Address
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Address Line | PMB 320 AVE MUNOZ RIVERA 1575
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City | PONCE
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State | PR
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Zip | 00717-0211
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Country | US
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Telephone | 787-259-5151
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Fax | 787-290-4472
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. VITA FERRARO
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Credential | CEO
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Telephone | 787-259-5151
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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 | 1142
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License Number State | PR
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