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Individual

JOSE L OLIVER SEGARRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
611 AVE ANDALUCIA, SAN JUAN, PR 00920-5310
(787) 626-6164
Mailing address
BDA MARIANI CALLE WILSON 1933, PONCE, PR 00717
(787) 420-9267

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
003529
PR
1223G0001X
General Practice Dentistry
Primary
2025052674
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/04/2024
Last updated
05/19/2026
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