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General NPI Number Information
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NPI Number | 1366658684
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Entity Type | Organization
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Legal Business Name | CENTRO DENTAL MONSERRATE
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CALLE 401 BLOQ143 #6 VILLA CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-768-0485
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE 401 BLOQ143 #6 VILLA CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00985
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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 | PRESIDENT
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Name | DR. MARIA M BERMUDEZ
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Credential | DMD.
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Telephone | 787-768-0485
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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 | 2391
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License Number State | PR
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