| Soc Cirugia Oral Y Maxilofacial | |
|
570 Calle Napoles Ste 208 Concordia Gardens Shopping Ctr Rio Piedras PR 00924-4605 | |
| (787) 755-4347 | |
| (787) 283-7440 |
| Full Name | Soc Cirugia Oral Y Maxilofacial |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 570 Calle Napoles Ste 208, Rio Piedras, Puerto Rico |
| Authorized Official Name and Position | Emma Gisela Montanez (ADMINISTRATOR) |
| Authorized Official Contact | 7873741181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soc Cirugia Oral Y Maxilofacial Po Box 29736 San Juan PR 00929-0736 Ph: (787) 755-4347 | Soc Cirugia Oral Y Maxilofacial 570 Calle Napoles Ste 208 Concordia Gardens Shopping Ctr Rio Piedras PR 00924-4605 Ph: (787) 755-4347 |
| NPI Number | 1649485657 |
|---|---|
| Provider Enumeration Date | 05/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649485657 | NPI | - | NPPES |
| 004-0826CI | Other | PR | SSS PROVIDER NOMBER |
| 067099 | Other | PR | LA CRUZ AZUL PROVIDER NOM |
| 4390 | Other | PR | PMC PROVIDER NOMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Puerto Rico) | Primary |
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