| Dental Services Organization, Llc | |
|
Boulevard Plaza De Rio Ramal 3 Ave Nicanor Humacao PR 00741-0000 | |
| (787) 622-3000 | |
| (787) 620-5384 |
| Full Name | Dental Services Organization, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | Boulevard Plaza De Rio Ramal 3, Humacao, Puerto Rico |
| Authorized Official Name and Position | Johanna Morales (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 00936-0000 Ph: (787) 622-3000 | Dental Services Organization, Llc Boulevard Plaza De Rio Ramal 3 Ave Nicanor Humacao PR 00741-0000 Ph: (787) 622-3000 |
| NPI Number | 1770368805 |
|---|---|
| Provider Enumeration Date | 08/28/2023 |
| Last Update Date | 08/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770368805 | NPI | - | NPPES |
| 039465701 | Medicaid | PR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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