MEDICARE: DR. FRANCISCO JOSE DE MARI MONSERRATE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2589	PR

General Provider Information

NPI Number	:	1053309187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCISCO JOSE DE MARI MONSERRATE DMD

Provider Business Mailing Address
First Line	:	844 CALLE HOSTOS
Second Line	:	URB HYDE PARK
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00927-4278
Country	:	US
Telephone Number	:	787-767-5435
Fax Number	:	787-766-2102

Provider Business Practice Location Address
First Line	:	844 CALLE HOSTOS
Second Line	:	URB HYDE PARK
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00927-4278
Country	:	US
Telephone Number	:	787-767-5435
Fax Number	:	787-766-2102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	07/08/2007

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