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General NPI Number Information
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NPI Number | 1679379390
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Entity Type | Organization
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Legal Business Name | CRUZ DE LA CRUZ PROSTHODONTICS LLC
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 1018 AVE ASHFORD STE 201
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City | SAN JUAN
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State | PR
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Zip | 00907-1137
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Country | US
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Telephone | 787-998-7778
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Fax |
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Provider Business Mailing Address
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Address Line | URB MONTE ORO 1 CAMINO EL MUDO APT 21
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROSTHODONTIST
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Name | ANGEL DAMIAN CRUZ DE LA CRUZ
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Credential | DMD
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Telephone | 787-998-7778
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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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