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NPI 1942401526

NPI 1942401526 : PAULA C SERVICIOS DENTAES, CSP : LAJAS, PR

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General NPI Number Information
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    NPI Number           |    1942401526
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    Entity Type          |    Organization 
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    Legal Business Name  |    PAULA C SERVICIOS DENTAES, CSP 
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Dates
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    Enumeration Date     |    05/30/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    INFANTERIA SUR STREET #80 
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    City                 |    LAJAS
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    State                |    PR
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    Zip                  |    00667
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    Country              |    US
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    Telephone            |    787-899-4925
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1521 
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    City                 |    LAJAS
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    State                |    PR
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    Zip                  |    00667-1521
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    Country              |    US
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    Telephone            |    787-899-4925
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. JAN A. MATTEI-MOLINI 
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    Credential           |    DDS
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    Telephone            |    787-899-4925
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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       |    02152
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    License Number State |    PR
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