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Organization
CAVITY REPAIR LLC
Active
Organization
CAVITY REPAIR LLC
Active
Parent organization
CAVITY REPAIR LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAVITY REPAIR LLC
Authorized official
MR. EDWIN E LAFONTAINE DMD (DENTIST)
(787) 515-7036
Entity
Organization
Contact information
Practice address
PALMAS PLANTATION, 122, HUMACAO, PR 00791-6022
(787) 515-7036
(787) 885-0560
Mailing address
122 PALMAS PLANTATION, TEE STREET, HUMACAO, PR 00791-6022
(787) 515-7136
(787) 885-0560
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2080
PR
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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