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General NPI Number Information
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NPI Number | 1902874712
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Entity Type | Organization
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Legal Business Name | DENTO-LAB, INC
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | CARR #2, RM 174, SUITE 101 SAN GERMAN MEDICAL PLAZA
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City | SAN GERMAN
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State | PR
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Zip | 00683-9339
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Country | US
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Telephone | 787-892-8585
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Fax | 787-892-8585
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Provider Business Mailing Address
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Address Line | HC 03 BOX 25708 SAN GERMAN MEDICAL PLAZA
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City | SAN GERMAN
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State | PR
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Zip | 00683-9339
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Country | US
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Telephone | 787-892-8585
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Fax | 787-892-8585
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Authorized Official
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Title or Position | PRESIDENT-DENTO-LAB, INC
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Name | FREDICKSON M. VARGAS
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Credential | MD
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Telephone | 787-892-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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