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General NPI Number Information
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NPI Number | 1346957396
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Entity Type | Organization
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Legal Business Name | CUPEY DENTAL GALLERY LLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | AVE. SAN CLAUDIO 390 URB. SAGRADO CORAZON
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City | SAN JUAN
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State | PR
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Zip | 00926-0092
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Country | US
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Telephone | 787-748-2025
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Fax |
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Provider Business Mailing Address
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Address Line | HC 67 BOX 15090
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City | BAYAMON
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State | PR
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Zip | 00956-9510
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Country | US
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Telephone | 787-664-0935
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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. DENISHA BERRIOS
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Credential | DMD
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Telephone | 787-664-0935
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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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