Provider Demographics
NPI:1386371409
Name:JRL DENTAL SERVICES
Entity type:Organization
Organization Name:JRL DENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNARYS
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA LEBRON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-585-2820
Mailing Address - Street 1:PO BOX 1090
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-1090
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVE LUIS MUNOZ MARIN, VILLA CARMEN
Practice Address - Street 2:I-20
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00972
Practice Address - Country:US
Practice Address - Phone:787-258-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty