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General NPI Number Information
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NPI Number | 1316174170
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH MANAGEMENT CORP
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 621 CALLE 14 AVE A
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City | SANTURCE
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-908-2992
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Fax | 787-268-0310
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Provider Business Mailing Address
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Address Line | 621 CALLE 14
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City | SAN JUAN
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State | PR
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Zip | 00915-4129
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Country | US
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Telephone | 787-908-2992
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Fax | 787-268-0310
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Authorized Official
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Title or Position | ADMINISTRADOR
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Name | JOSE A PEREZ TRIAS
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Credential |
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Telephone | 787-908-2992
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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 | PR
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