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General NPI Number Information
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NPI Number | 1790007730
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Entity Type | Organization
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Legal Business Name | DR. OLIVER & ASOCIADOS DENTISTAS
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 600 BOULEVARD DE LOS ARBOLES #393 ARBOLES DE MONTEHIEDRA
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-380-5157
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Fax | 787-731-4268
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Provider Business Mailing Address
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Address Line | 600 BOULEVARD 393 ARBOLES DE MONTEHIEDRA
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-380-5157
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. FERNANDO A. OLIVER JR.
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Credential | DDS
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Telephone | 787-380-5157
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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 | 5507
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License Number State | PR
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