# DIETRICH DENTAL P.S.C

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

## Provider details

- **NPI number:** 1689819260
- **Authorized official:** DR. RENE DIETRICH-TRIGO DMD (DENTIST)
- **Authorized official phone:** (787) 705-5063

## Contact information

- **Practice address:** LA GALERIA SUCHVILLE 97 CARR 2, STE 208, GUAYNABO, PR 00966
- **Practice address phone:** (787) 705-5063
- **Practice address fax:** (787) 705-5065
- **Mailing address:** LA GALERIA SUCHVILLE 97, CARR. 2 SUITE 208, GUAYNABO, PR 00966
- **Mailing address phone:** (787) 705-5063
- **Mailing address fax:** (787) 705-5065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 2179 | PR | Yes |

## Other

- **Enumeration date:** 12/10/2008
- **Last updated:** 12/10/2008