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General NPI Number Information
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NPI Number | 1912993395
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Entity Type | Individual
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Provider Name | PEDRO J RUIZ LUGO D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | AMISTAD #38
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City | LAJAS
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State | PUERTO RICO
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Zip | 00667
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Country | UM
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Telephone | 787-899-2298
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Fax |
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Provider Business Mailing Address
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Address Line | 38 CALLE AMISTAD
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City | LAJAS
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State | PR
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Zip | 00667-2060
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Country | US
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Telephone | 787-899-2298
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Fax | 787-899-2298
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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 | 0947
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License Number State | PR
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