Provider Demographics
NPI:1912128380
Name:PEREZ&ALVARDO DENTAL OFFICE
Entity type:Organization
Organization Name:PEREZ&ALVARDO DENTAL OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITZY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-857-3381
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0568
Mailing Address - Country:US
Mailing Address - Phone:787-857-3381
Mailing Address - Fax:787-857-3381
Practice Address - Street 1:CARR 152, KM 1.5, BO QUEBRADILLAS
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-0568
Practice Address - Country:US
Practice Address - Phone:787-857-3381
Practice Address - Fax:787-857-3381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty