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General NPI Number Information
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NPI Number | 1811039217
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Entity Type | Organization
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Legal Business Name | J&ADENTALPSC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 2981 AVE MILITAR STE 1
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City | ISABELA
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State | PR
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Zip | 00662-4075
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Country | US
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Telephone | 787-830-2060
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Fax | 787-830-2253
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Provider Business Mailing Address
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Address Line | PO BOX 604
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City | SAN ANTONIO
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State | PR
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Zip | 00690-0604
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Country | US
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Telephone | 787-830-2060
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Fax | 787-830-2253
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Authorized Official
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Title or Position | SECRETARIA
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Name | MISS AROCHO MEDINA MARTA
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Credential |
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Telephone | 787-830-2060
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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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