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General NPI Number Information
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NPI Number | 1891965802
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Entity Type | Individual
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Provider Name | JOSE MANUEL HERNANDEZ LORING DMD MPH MS
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Gender | Male
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 65 INF AVE KIM 14.7 LOS COLOBOS SH CTER CINEMA BUILD SUITE 201
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City | CAROLINA
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State | PR
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Zip | 00987
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Country | US
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Telephone | 787-776-0814
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Fax | 787-776-0805
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Provider Business Mailing Address
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Address Line | PO BOX 361916
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City | SAN JUAN
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State | PR
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Zip | 00936-1916
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 988
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License Number State | PR
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