| San Juan Dental Center Llc | |
|
456 Calle Cesar Gonzalez San Juan PR 00918-2628 | |
| (787) 645-0089 | |
| Not Available |
| Full Name | San Juan Dental Center Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 456 Calle Cesar Gonzalez, San Juan, Puerto Rico |
| Authorized Official Name and Position | Rosa Maria Rodriguez (DOCTOR) |
| Authorized Official Contact | 7876450089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Juan Dental Center Llc 456 Calle Cesar Gonzalez San Juan PR 00918-2628 Ph: (787) 645-0089 | San Juan Dental Center Llc 456 Calle Cesar Gonzalez San Juan PR 00918-2628 Ph: (787) 645-0089 |
| NPI Number | 1083198576 |
|---|---|
| Provider Enumeration Date | 09/20/2018 |
| Last Update Date | 09/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083198576 | NPI | - | NPPES |
| 582837989 | Medicaid | PR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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