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General NPI Number Information
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NPI Number | 1902878812
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Entity Type | Individual
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Provider Name | GIL ALBERTO DIAZ D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 55 CALLE DR GOYCO
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City | CAGUAS
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State | PR
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Zip | 00725-2624
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Country | US
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Telephone | 787-747-1035
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Fax | 787-747-1035
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Provider Business Mailing Address
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Address Line | BOX 6256
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-747-1035
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Fax | 787-747-1035
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1343
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License Number State | PR
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