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General NPI Number Information
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NPI Number | 1699414508
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Entity Type | Organization
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Legal Business Name | CN DENTAL LLC
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | MENDEZ VIGO OESTE
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-464-4142
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Fax |
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Provider Business Mailing Address
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Address Line | CONDOMINIO LA CIMA 404A URB PASEO LOS ROBLES
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City | MAYAGUEZ
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State | PR
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Zip | 00682
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Country | US
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Telephone | 787-464-4142
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | UBALDINO RAMIREZ DE ARELLANO PONCE
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Credential | DMD
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Telephone | 787-375-4425
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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 |
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License Number State |
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