Provider Demographics
NPI:1124233507
Name:JIMENEZ Y SALDANA DENTISTAS CSP
Entity type:Organization
Organization Name:JIMENEZ Y SALDANA DENTISTAS CSP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALDANA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-720-1684
Mailing Address - Street 1:CENTRO COMERCIAL LA CUMBRE
Mailing Address - Street 2:LOCAL # 3
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-720-1684
Mailing Address - Fax:787-708-5272
Practice Address - Street 1:CENTRO COMERCIAL LA CUMBRE
Practice Address - Street 2:LOCAL # 3
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-720-1684
Practice Address - Fax:787-708-5272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty