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General NPI Number Information
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NPI Number | 1487999835
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Entity Type | Organization
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Legal Business Name | MV ORTHODONTICS PSC
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | B3 REPTO MENDOZA
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City | HUMACAO
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State | PR
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Zip | 00791-3737
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Country | US
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Telephone | 787-850-2600
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Fax | 787-850-7779
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Provider Business Mailing Address
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Address Line | B3 REPTO MENDOZA
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City | HUMACAO
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State | PR
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Zip | 00791-3737
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Country | US
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Telephone | 787-850-2600
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Fax | 787-850-7779
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NOEL MOLINI
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Credential | DMD, MS
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Telephone | 787-850-2600
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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 | 438
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License Number State | PR
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