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General NPI Number Information
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NPI Number | 1376909960
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Entity Type | Organization
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Legal Business Name | WHITE TEETH DENTAL CARE, CORP.
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | HP13 CALLE AMALIA PAOLI 7MA SECCION LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949-3606
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Country | US
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Telephone | 787-795-0320
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Fax | 787-795-0320
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Provider Business Mailing Address
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Address Line | HP13 CALLE AMALIA PAOLI 7MA SECCION LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949-3606
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Country | US
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Telephone | 787-795-0320
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Fax | 787-795-0320
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Authorized Official
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Title or Position | OWNER
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Name | DR. FIOR BLANCO
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Credential |
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Telephone | 787-795-0320
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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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