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NPI 1467429316

NPI 1467429316 : ISABEL C BOSCIO DMD : SAN JUAN, PR

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General NPI Number Information
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    NPI Number           |    1467429316
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    Entity Type          |    Individual 
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    Provider Name        |    ISABEL C BOSCIO DMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/28/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1311 AVE AMERICO MIRANDA 
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    City                 |    SAN JUAN
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    State                |    PR
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    Zip                  |    00921-2118
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    Country              |    US
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    Telephone            |    787-793-2810
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1026 AVE LUIS VIGOREAUX APT 11 D
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    City                 |    GUAYNABO
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    State                |    PR
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    Zip                  |    00966-2506
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    Country              |    US
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    Telephone            |    787-781-7118
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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       |    2653
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    License Number State |    PR
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