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General NPI Number Information
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NPI Number | 1477610442
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Entity Type | Organization
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Legal Business Name | BARCELONETA PRIMARY HEALTH SERVICES INC. (DENTAL)
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | BOX 2045
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City | BARCELONETA
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State | PR
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Zip | 00617-2045
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Country | US
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Telephone | 787-846-4412
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Fax | 787-846-7410
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Provider Business Mailing Address
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Address Line | PO BOX 2045
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City | BARCELONETA
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State | PR
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Zip | 00617-2045
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Country | US
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Telephone | 787-846-4412
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Fax | 787-846-7410
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LEIDA A NAZARIO
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Credential | MHSA
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Telephone | 787-846-4412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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