Provider Demographics
NPI:1215990387
Name:SERVICIOS DENTALES DEL CENTRO, CSP
Entity type:Organization
Organization Name:SERVICIOS DENTALES DEL CENTRO, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-279-6007
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0341
Mailing Address - Country:US
Mailing Address - Phone:787-279-6007
Mailing Address - Fax:787-799-5301
Practice Address - Street 1:BO BUENA VISTA
Practice Address - Street 2:CARR 167 KM 14.0
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-279-6007
Practice Address - Fax:787-799-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty