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General NPI Number Information
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NPI Number | 1477172385
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Entity Type | Individual
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Provider Name | LYNN MARIE PEREZ MARTY
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Gender | Female
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | COND. STELLA ROYAL #104
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City | RINCON
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State | PR
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Zip | 00677
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Country | US
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Telephone | 787-243-6436
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60401 PMB 116
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City | SAN ANTONIO
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State | PR
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Zip | 00690
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Country | US
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Telephone | 787-243-6436
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3359
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License Number State | PR
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