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NPI Code Detail

MEDICARE: OFICINA DENTAL DRA. MICHELLE RECIO PSC

MEDICARE: OFICINA DENTAL DRA. MICHELLE RECIO PSC
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
1261QD0000XDental Clinic/Center2332PR

General Provider Information

NPI Number : 1467588038
Entity Type Code : Organization
Provider Name (Legal Business Name) : OFICINA DENTAL DRA. MICHELLE RECIO PSC
Provider Business Mailing Address
First Line : 6300 AVE ISLA VERDE
Second Line : COND. LA MANCHA APT. 212
City : CAROLINA
State : PR
Zip : 00979-7153
Country : US
Telephone Number : 787-824-7293
Fax Number : 787-824-7293
Provider Business Practice Location Address
First Line : 8 CALLE COLON PACHECO
Second Line :
City : SALINAS
State : PR
Zip : 00751-3344
Country : US
Telephone Number : 787-824-7293
Fax Number : 787-824-7293
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHELLE MARIE RECIO
Credential : DMD
Telephone Number : 787-824-7293
Provider Enumeration Date : 02/26/2007
Last Update Date : 08/22/2020

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