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NPI Code Detail

MEDICARE: DR. JOSE R GOMEZ DMD

MEDICARE: DR. JOSE R GOMEZ 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
11223G0001XGeneral Practice Dentistry2408PR

General Provider Information

NPI Number : 1316922701
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE R GOMEZ DMD
Provider Business Mailing Address
First Line : HC 1 BOX 29030
Second Line : DPT 523
City : CAGUAS
State : PR
Zip : 00725-8900
Country : US
Telephone Number : 787-731-2790
Fax Number : 787-272-2185
Provider Business Practice Location Address
First Line : CARRETERA 173 KM 8.9
Second Line : BARRIO RIOS
City : GUAYNABO
State : PR
Zip : 00971
Country : US
Telephone Number : 787-731-2790
Fax Number : 787-272-2185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 06/19/2013

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Directions to “ DR. JOSE R GOMEZ DMD” Practice Location

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