# WISCO ORAL SURGERY LLC

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

## Provider details

- **NPI number:** 1407535214
- **Authorized official:** DR. ANDRES GUSTAVO WISCOVITCH TURNEY DMD,MSD (PRESIDENT)
- **Authorized official phone:** (727) 235-3912

## Contact information

- **Practice address:** EDIFICIO GUAYACAN 202 CALLE CINTRON SUITE 221, AIBONITO, PR 00705
- **Practice address phone:** (787) 520-7148
- **Mailing address:** PO BOX 13004, SAN JUAN, PR 00908-3004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 07/18/2023
- **Last updated:** 07/18/2023