# CR DIAZ BONILLA DENTISTA PEDIATRICA PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255707568
- **Authorized official:** DR. CAREM ROSA DIAZ DMD (PRINCIPAL)
- **Authorized official phone:** (787) 447-0892

## Contact information

- **Practice address:** 51 AVE SAN JOSE, SUITE 203, AIBONITO, PR 00705
- **Practice address phone:** (787) 735-0575
- **Practice address fax:** (787) 735-2390
- **Mailing address:** E28 CALLE 14, URB QUINTAS DE CUPEY, SAN JUAN, PR 00926
- **Mailing address phone:** (787) 735-0575
- **Mailing address fax:** (787) 735-2390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 2334 | PR | Yes |

## Other

- **Enumeration date:** 08/20/2015
- **Last updated:** 08/20/2015