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General NPI Number Information
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NPI Number | 1649262437
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Entity Type | Individual
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Provider Name | JOSE ANTONIO CINTRON SOSTRE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 1105 N. LAFAYETTE DR SUITE C
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City | SUMTER
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State | SC
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Zip | 29150-2984
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Country | US
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Telephone | 803-774-3600
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Fax | 803-774-4560
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Provider Business Mailing Address
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Address Line | 1105 N. LAFAYETTE DR SUITE C
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City | SUMTER
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State | SC
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Zip | 29150-2984
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Country | US
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Telephone | 803-774-3600
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Fax | 803-774-4560
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 0401415038
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License Number State | VA
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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 | 2416
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9725
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License Number State | SC
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