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General NPI Number Information
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NPI Number | 1316697402
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Entity Type | Organization
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Legal Business Name | VRM PROSTHODONTICS
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | CARR 167 URB MONTANEZ NUM 11
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City | BAYAMON
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State | PR
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Zip | 00957
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Country | US
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Telephone | 787-269-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 675 SERGIO CUEVAS BUSTAMANTE APT 1504
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-613-0433
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTOR A RIVERA
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Credential | DMD,MS
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Telephone | 787-613-0433
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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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