Provider Demographics
NPI:1326876608
Name:JYF DENTAL CLINIC INC
Entity type:Organization
Organization Name:JYF DENTAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAMILIA GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:787-275-4019
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00963
Mailing Address - Country:US
Mailing Address - Phone:787-529-1066
Mailing Address - Fax:
Practice Address - Street 1:BARBOSA AVE 119
Practice Address - Street 2:ESQ PROGRESO
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-275-4019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental