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General NPI Number Information
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NPI Number | 1942539697
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Entity Type | Organization
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Legal Business Name | OFICINA BIOESTETICA DENTAL, CORP
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | CALLE LODI 601 VILLA CAPRI
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City | RIO PIEDRAS
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-763-8797
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Fax | 787-250-9589
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Provider Business Mailing Address
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Address Line | PO BOX 892
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City | SAINT JUST
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State | PR
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Zip | 00978-0892
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Country | US
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Telephone | 787-763-8797
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Fax | 787-250-9589
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. EMILIO A JIMENEZ COLON
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Credential | D.M.D.
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Telephone | 787-250-9589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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