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General NPI Number Information
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NPI Number | 1437036217
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Entity Type | Organization
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Legal Business Name | PERIODONTIC SOLUTIONS LLC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 400 AVE FD ROOSEVELT STE 508
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City | SAN JUAN
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State | PR
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Zip | 00918-2163
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Country | US
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Telephone | 787-777-1163
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Fax |
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Provider Business Mailing Address
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Address Line | 400 AVE FD ROOSEVELT STE 508
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City | SAN JUAN
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State | PR
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Zip | 00918-2163
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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 | SOLE MEMBER
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Name | FABIOLA VICTORIA RAMIREZ MARTINEZ
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Credential | DMD
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Telephone | 787-402-6759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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