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General NPI Number Information
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NPI Number | 1801021746
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Entity Type | Organization
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Legal Business Name | LAS PIEDRAS DENTAL GROUP P.S.C.
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 85 CALLE JOSE CELSO BARBOSA
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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Country | US
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Telephone | 787-647-7330
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Fax |
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Provider Business Mailing Address
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Address Line | 85 CALLE JOSE CELSO BARBOSA
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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Country | US
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Telephone | 787-647-7330
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIRIAM TORRES MARRER
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Credential | DMD
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Telephone | 787-647-7330
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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 |
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License Number State |
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