Provider Demographics
NPI:1124459755
Name:OFICINA DENTAL CABRERA & NUNEZ
Entity type:Organization
Organization Name:OFICINA DENTAL CABRERA & NUNEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-642-0835
Mailing Address - Street 1:16 VALLE ESCONDIDO
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-8000
Mailing Address - Country:US
Mailing Address - Phone:787-273-1410
Mailing Address - Fax:787-706-1292
Practice Address - Street 1:611 AVE ANDALUCIA
Practice Address - Street 2:PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-5310
Practice Address - Country:US
Practice Address - Phone:787-273-1410
Practice Address - Fax:787-706-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-08
Last Update Date:2013-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2415261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental