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General NPI Number Information
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NPI Number | 1851494199
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Entity Type | Individual
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Provider Name | JAN ALEXIS MATTEI-MOLINI DDS
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | #80 CALLE 65 INFANTERIA SUR
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City | LAJAS
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State | PR
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Zip | 00667
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Country | US
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Telephone | 787-899-4925
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1521
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City | LAJAS
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State | PR
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Zip | 00667-1521
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Country | US
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Telephone | 787-899-4925
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 02152
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License Number State | PR
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