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General NPI Number Information
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NPI Number | 1639219322
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Entity Type | Individual
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Provider Name | MICHELLE M RECIO DMD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8 CALLE E SUR-MED MEDICAL CENTER
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City | SALINAS
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State | PR
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Zip | 00751-2836
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Country | US
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Telephone | 787-824-7293
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Fax | 787-824-7293
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Provider Business Mailing Address
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Address Line | 6300 AVE ISLA VERDE COND. LA MANCHA APT. 212
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City | CAROLINA
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State | PR
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Zip | 00979-7153
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Country | US
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Telephone | 787-824-7293
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Fax | 787-824-7293
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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 | 2332
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14703
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License Number State | FL
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