Provider Demographics
NPI:1104052455
Name:ESCUELA DE MEDICINA DENTAL
Entity type:Organization
Organization Name:ESCUELA DE MEDICINA DENTAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDANYR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-728-4190
Mailing Address - Street 1:PO BOX 365067
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-728-4190
Mailing Address - Fax:787-728-4190
Practice Address - Street 1:608 AVE BARBOSA
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00915-3203
Practice Address - Country:US
Practice Address - Phone:787-728-4190
Practice Address - Fax:787-728-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty