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Organization
AR DENTAL CLINIC LLC
Active
Organization
AR DENTAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADA RIVERA RDA (PRESIDENT)
(787) 734-0330
Entity
Organization
Contact information
Practice address
#17 CALLE DANIEL FLORES, JUNCOS, PR 00777-3410
(787) 734-0330
Mailing address
PO BOX 2473, JUNCOS, PR 00777-2473
(787) 734-0330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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