| Third Molar Inc | |
|
I47 Calle I Extension Hermanas Davila Bayamon PR 00959-5266 | |
| (787) 786-8540 | |
| (787) 995-0431 |
| Full Name | Third Molar Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | I47 Calle I, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Rafael E Ramirez Diaz (OWNER) |
| Authorized Official Contact | 7877868540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Third Molar Inc 429 Calle Rey Luis La Villa De Torrimar Guaynabo PR 00969-3170 Ph: (787) 786-8540 | Third Molar Inc I47 Calle I Extension Hermanas Davila Bayamon PR 00959-5266 Ph: (787) 786-8540 |
| NPI Number | 1750712162 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 12/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750712162 | NPI | - | NPPES |
| 1467450809 | Medicaid | PR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 1997 (Puerto Rico) | Primary |
Grupo Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: Casa Lina Ave. #1 Suite 101, 177 Route Los Filtros, Bayamon, PR 00969 Phone: 787-789-1919 Fax: 787-789-1921 | |
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