# JRC MAXILLOFACIAL SERVICES,PSC

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

## Provider details

- **NPI number:** 1689980682
- **Authorized official:** DR. JUAN RAMON RIVERA DMD (PRESIDENTE)
- **Authorized official phone:** (787) 852-4685

## Contact information

- **Practice address:** GARRIDO MORALES 53, FAJARDO, PR 00738-1087
- **Practice address phone:** (787) 863-2549
- **Mailing address:** 6 CALLE FLOR GERENA N, HUMACAO, PR 00791-4293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 995 | PR | Yes |

## Other

- **Enumeration date:** 08/27/2010
- **Last updated:** 08/27/2010