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Organization
PRO ESTHETIC DENTAL LLC
Active
Organization
PRO ESTHETIC DENTAL LLC
Active
Other names
Pro Esthetic Dental LLC
Organization subpart
No
Provider details
NPI number
Authorized official
NADYAN VARGAS DMD (DMD)
(787) 265-3683
Entity
Organization
Contact information
Practice address
114 CALLE DE LA CANDELARIA W STE 107, MAYAGUEZ, PR 00680
(787) 265-3683
Mailing address
114 CALLE DE LA CANDELARIA W STE 107, MAYAGUEZ, PR 00680
(787) 265-3683
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0700X
Prosthodontics
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990219417
—
PR
Enumeration date
11/24/2021
Last updated
11/24/2021
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