Provider Demographics
NPI:1366619801
Name:OFICINA DENTAL LASER DR. NUNEZ, P.S.C.
Entity type:Organization
Organization Name:OFICINA DENTAL LASER DR. NUNEZ, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-883-8846
Mailing Address - Street 1:PO BOX 1627
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-1627
Mailing Address - Country:US
Mailing Address - Phone:787-883-8846
Mailing Address - Fax:
Practice Address - Street 1:STATE ROAD #2 KM 29.4
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-1627
Practice Address - Country:US
Practice Address - Phone:787-883-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRD1939261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental