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General NPI Number Information
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NPI Number | 1639894058
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Entity Type | Organization
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Legal Business Name | OFICINA DENTAL DR PACHECO LLC
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Dates
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Enumeration Date | 10/07/2022
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | URB SANTA ROSA AVE AGUAS BUENAS 20 BLQ 38
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City | BAYAMAON
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State | PR
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Zip | 00959-0095
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Country | US
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Telephone | 787-409-7480
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Fax |
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Provider Business Mailing Address
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Address Line | COND ARCOS DE SUCHVILLE 80 CALLE 3 APT 310
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City | BAYAMON
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State | PR
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Zip | 00960
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Country | US
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Telephone | 787-409-7480
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. LUIS A PACHECO PEREZ
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Credential | DMD
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Telephone | 787-409-7480
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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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