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General NPI Number Information
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NPI Number | 1437548658
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Entity Type | Individual
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Provider Name | JOSE JUAN NUNEZ-ORTA DMD
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Gender | Male
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 2053 PONCE BY PASS EDIFICIO CENTRO CARIBE SUITE 202
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City | PONCE
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State | PR
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Zip | 00717-1308
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Country | US
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Telephone | 787-244-7410
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Fax |
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Provider Business Mailing Address
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Address Line | 2053 PONCE BY PASS EDIFICIO CENTRO CARIBE SUITE 202
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City | PONCE
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State | PR
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Zip | 00717-0000
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Country | US
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Telephone | 787-244-7410
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Fax |
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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 | 3185
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License Number State | PR
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