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General NPI Number Information
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NPI Number | 1780892323
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Entity Type | Organization
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Legal Business Name | GAMENEZ DENTAL CORPORATION
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 407 DEL PARQUE ST THIRD FLOOR
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City | SAN JUAN
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State | PR
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Zip | 00912
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Country | US
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Telephone | 787-721-3627
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Fax | 787-721-3650
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Provider Business Mailing Address
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Address Line | PO BOX 8047
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City | SAN JUAN
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State | PR
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Zip | 00910-0047
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Country | US
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Telephone | 787-721-3627
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Fax | 787-721-3650
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Authorized Official
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Title or Position | OWNER
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Name | DR. GABRIEL JIMENEZ PUIG
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Credential | DMD
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Telephone | 787-721-3627
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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 | 389
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License Number State | PR
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