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NPI Code Detail

MEDICARE: SONRISAS HERMOSAS, CSP

MEDICARE: SONRISAS HERMOSAS, CSP
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
1302F00000XExclusive Provider Organization1865PR

General Provider Information

NPI Number : 1770731259
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONRISAS HERMOSAS, CSP
Provider Business Mailing Address
First Line : PO BOX 1527
Second Line :
City : TRUJILLO ALTO
State : PR
Zip : 00977-1527
Country : US
Telephone Number : 787-756-6125
Fax Number : 787-756-6125
Provider Business Practice Location Address
First Line : CALLE MARGINAL
Second Line : ROAD 1 KM. 16.1
City : BAYAMON
State : PR
Zip : 00957-2536
Country : US
Telephone Number : 787-756-6125
Fax Number : 787-756-6125
Authorized Official
Title or Position : PRESIDENT
Name : DR. ELAINE M. PAGAN
Credential : DMD
Telephone Number : 787-756-6125
Provider Enumeration Date : 09/08/2008
Last Update Date : 09/08/2008

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Directions to “SONRISAS HERMOSAS, CSP ” Practice Location

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