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General NPI Number Information
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NPI Number | 1750415402
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Entity Type | Organization
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Legal Business Name | ALL ORTHODONTICS SERVICES, PSC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1311 AVE AMERICO MIRANDA
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City | SAN JUAN
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State | PR
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Zip | 00921-2118
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Country | US
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Telephone | 787-792-2850
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Fax | 787-749-0406
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Provider Business Mailing Address
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Address Line | 1311 AVE AMERICO MIRANDA
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City | SAN JUAN
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State | PR
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Zip | 00921-2118
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Country | US
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Telephone | 787-792-2850
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Fax | 787-749-0406
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID SANTIAGO
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Credential |
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Telephone | 787-792-2850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1520
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License Number State | PR
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