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General NPI Number Information
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NPI Number | 1326910852
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Entity Type | Organization
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Legal Business Name | DENTAL PLACE LLC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 979 AVE AMERICO MIRANDA
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City | SAN JUAN
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State | PR
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Zip | 00921-2801
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Country | US
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Telephone | 787-764-5070
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 364366
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City | SAN JUAN
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State | PR
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Zip | 00936-4366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. DESIREE MARLEINE ROSICH
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Credential | DMD
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Telephone | 787-397-2938
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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 |
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License Number State |
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