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General NPI Number Information
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NPI Number | 1689731770
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Entity Type | Individual
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Provider Name | LUIS E ORTIZ ARCHILLA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 1482 F.D. ROOSEVELT AVE. BUILDING 3 STE. 6
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City | SAN JUAN
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State | PR
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Zip | 00920
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Country | US
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Telephone | 787-370-3073
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Fax | 787-781-8389
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Provider Business Mailing Address
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Address Line | PO BOX 365011
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City | SAN JUAN
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State | PR
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Zip | 00936-5011
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Country | US
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Telephone | 787-370-3073
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Fax | 787-781-8389
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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 | 2223
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License Number State | PR
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