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General NPI Number Information
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NPI Number | 1942200167
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Entity Type | Individual
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Provider Name | GRACIELA ROSARIO DMD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | CALLE PEDRO ROSARIO SUITE K-11
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City | AIBONITO
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State | PR
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Zip | 00705-2055
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Country | US
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Telephone | 787-735-5999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2055
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City | AIBONITO
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State | PR
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Zip | 00705-2055
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Country | US
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Telephone | 787-735-5999
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1267
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License Number State | PR
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