MEDICARE: DR. JUAN LUIS MOLINA-NEGRON 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	1223G0001X	General Practice Dentistry	2387	PR

General Provider Information

NPI Number	:	1194746644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN LUIS MOLINA-NEGRON DMD

Provider Business Mailing Address
First Line	:	QUANTUM METROCENTER #120 AVE CHARDON , STE 142
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-1732
Country	:	US
Telephone Number	:	787-402-2834
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 AVE LAUREL
Second Line	:	HOSPITAL REGIONAL BAYAMON
City	:	BAYAMON
State	:	PR
Zip	:	00956-4816
Country	:	US
Telephone Number	:	787-402-2834
Fax Number	:

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	08/25/2017

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