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Organization
DENTAL GALLERY PSC
Active
Organization
DENTAL GALLERY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELISA M RIVERA D.M.D (DENTIST)
(787) 361-0015
Entity
Organization
Contact information
Practice address
MCS 466 AVE DE DIEGO 89, SUITE 105, SAN JUAN, PR 00927-5831
(787) 361-0015
Mailing address
MCS 466 AVE DE DIEGO 89, SUITE 105, SAN JUAN, PR 00927-5831
(787) 361-0015
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2736
PR
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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