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General NPI Number Information
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NPI Number | 1366542169
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Entity Type | Individual
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Provider Name | JESSICA MARIA PEREZ DMD
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | URB. VILLA REAL MARGINAL D12
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-858-9194
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Fax | 787-858-9194
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Provider Business Mailing Address
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Address Line | PLAZA 38 MG 8 MARINA BAHIA
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City | CATANO
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State | PR
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Zip | 00962
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Country | US
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Telephone | 787-858-9194
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Fax | 787-858-9194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2621
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License Number State | PR
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