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General NPI Number Information
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NPI Number | 1720700115
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Entity Type | Organization
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Legal Business Name | DR.DONALD MANGUAL PSC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 400 AVE FD ROOSEVELT STE 407
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City | SAN JUAN
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State | PR
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Zip | 00918-2163
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Country | US
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Telephone | 787-946-5556
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Fax |
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Provider Business Mailing Address
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Address Line | 400 AVE FD ROOSEVELT STE 407
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City | SAN JUAN
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State | PR
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Zip | 00918-2163
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Country | US
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Telephone | 787-946-5556
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Fax |
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Authorized Official
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Title or Position | PROSTHODONTICS
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Name | DR. DONALD MANGUAL SR.
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Credential | DMD MSD
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Telephone | 787-667-9910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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