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General NPI Number Information
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NPI Number | 1366619801
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Entity Type | Organization
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Legal Business Name | OFICINA DENTAL LASER DR. NUNEZ, P.S.C.
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | STATE ROAD #2 KM 29.4
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City | VEGA ALTA
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State | PR
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Zip | 00692-1627
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Country | US
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Telephone | 787-883-8846
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1627
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City | VEGA ALTA
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State | PR
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Zip | 00692-1627
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Country | US
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Telephone | 787-883-8846
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WILLIAM A NUNEZ
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Credential |
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Telephone | 787-883-8846
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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 | D1939
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License Number State | PR
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