Provider Demographics
NPI:1407693708
Name:K2B LLC
Entity type:Organization
Organization Name:K2B LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEISY
Authorized Official - Middle Name:
Authorized Official - Last Name:BONANO BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-223-1776
Mailing Address - Street 1:CARR. PR-842 KM. 12 H1 CAIMITO
Mailing Address - Street 2:CAMINO LOS ROMEROS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-531-3187
Mailing Address - Fax:
Practice Address - Street 1:CARR. PR-842 KM. 12 H1 CAIMITO
Practice Address - Street 2:CAMINO LOS ROMEROS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-531-3187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty