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General NPI Number Information
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NPI Number | 1477682433
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Entity Type | Individual
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Provider Name | OSVALDO MIGUEL MAESO DMD
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 845 CALLE MOLUCAS COUNTRY CLUB
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City | SAN JUAN
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State | PR
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Zip | 00924-1755
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Country | US
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Telephone | 787-757-1085
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Fax | 787-757-1405
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Provider Business Mailing Address
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Address Line | 3518 AVE. SUR APT. 10-12 THE RESIDENCES
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City | CAROLINA
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State | PR
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Zip | 00987
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Country | US
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Telephone | 787-776-2841
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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 | 2246
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License Number State | PR
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