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General NPI Number Information
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NPI Number | 1306495023
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Entity Type | Organization
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Legal Business Name | DC DENTAL, INC
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 61 CALLE DOMINGO CACERES W
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City | CAROLINA
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State | PR
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Zip | 00985-6010
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Country | US
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Telephone | 787-769-6880
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 840
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City | CAROLINA
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State | PR
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Zip | 00986-0840
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Country | US
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Telephone | 787-769-6880
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Fax |
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Authorized Official
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Title or Position | DMD
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Name | RAFAEL ANGEL DIAZ CANCEL
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Credential | DMD
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Telephone | 787-510-4519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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