# DENTISTAS MISIONEROS DE PR (DMDPR)

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

## Provider details

- **NPI number:** 1871042325
- **Authorized official:** DR. LILIAM ORTIZ DMD (PRESIDENT)
- **Authorized official phone:** (787) 852-8255

## Contact information

- **Practice address:** CALLE WILLIAM FONT FINAL, CLINICA DENTAL CDT CULEBRA, CULEBRA, PR 00775
- **Practice address phone:** (787) 742-0001
- **Practice address fax:** (787) 742-0176
- **Mailing address:** 58 CALLE MANUEL CRUZ, HUMACAO, PR 00791-3627
- **Mailing address phone:** (787) 852-1579
- **Mailing address fax:** (787) 852-8255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2452 | PR | Yes |

## Other

- **Enumeration date:** 09/26/2016
- **Last updated:** 09/26/2016