Organization
TRUJILLO DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE A VELAZQUEZ DMD (PRESIDENT)
(787) 755-3045
Entity
Organization
Contact information
Practice address
CALLE DR. FERNANDEZ, #206, TRUJILLO ALTO, PR 00976
(787) 755-3045
(787) 292-0277
Mailing address
CALLE DR. FERNANDEZ, #206, TRUJILLO ALTO, PR 00976
(787) 755-3045
(787) 292-0277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
450
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42573TR
SSS PROVIDER ID
PR
Enumeration date
02/13/2006
Last updated
08/22/2020
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