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General NPI Number Information
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NPI Number | 1538504568
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH GROUP
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Dates
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Enumeration Date | 05/03/2013
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | PP14 CALLE 5 URB. CANA
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City | BAYAMON
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State | PR
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Zip | 00957-6240
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Country | US
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Telephone | 787-998-5255
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Fax |
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Provider Business Mailing Address
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Address Line | PP14, CALLE 5 URB. CANA
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City | BAYAMON
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State | PR
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Zip | 00957
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Country | US
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Telephone | 787-998-5255
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS JOEL CINTRON
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Credential |
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Telephone | 787-998-5255
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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 | 2746
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License Number State | PR
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