| Dental Services Organization Llc | |
|
Mall Plaza Rial Carr 185 4a 4b Km 0.9 Canovanas PR 00729-0000 | |
| (939) 545-1399 | |
| (787) 622-5384 |
| Full Name | Dental Services Organization Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | Mall Plaza Rial, Canovanas, Puerto Rico |
| Authorized Official Name and Position | Johanna Morales Torres (ADMINISTRADORA) |
| Authorized Official Contact | 7876223000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Services Organization Llc Po Box 71114 San Juan PR 00936-8014 Ph: (787) 622-3000 | Dental Services Organization Llc Mall Plaza Rial Carr 185 4a 4b Km 0.9 Canovanas PR 00729-0000 Ph: (939) 545-1399 |
| NPI Number | 1578345518 |
|---|---|
| Provider Enumeration Date | 10/16/2023 |
| Last Update Date | 10/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578345518 | NPI | - | NPPES |
| 039465700 | Medicaid | PR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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