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General NPI Number Information
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NPI Number | 1861502320
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Entity Type | Organization
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Legal Business Name | CLINICA DENTAL BARBOSA INC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 597 AVE BARBOSA URB VALENCIA
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City | SAN JUAN
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State | PR
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Zip | 00923
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Country | US
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Telephone | 787-767-2331
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Fax | 787-756-7904
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Provider Business Mailing Address
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Address Line | PO BOX 270201
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City | SAN JUAN
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State | PR
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Zip | 00927-0201
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Country | US
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Telephone | 787-756-7904
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Fax | 787-756-7904
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. ANIBAL RODIRGUEZ-CABAN
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Credential | DMD
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Telephone | 787-756-7904
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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 | 2270
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License Number State | PR
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