Organization
TRUJILLO DENTAL CLINIC PSC
Active
Other names
TRUJILLO DENTAL CLINIC PSC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE VELAZQUEZ RAMON DMD (PRESIDENT)
(787) 755-3045
Entity
Organization
Contact information
Practice address
206 CALLE DR FERNANDEZ, 206 DR FERNANDEZ, TRUJILLO ALTO, PR 00976-5939
(787) 755-3045
(787) 292-0277
Mailing address
PO BOX 51597, PO BOX 51597, TOA BAJA, PR 00950-1597
(787) 755-3045
(787) 292-0277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0450
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083642029
NPI
PR
01
—
1114006079
NPI
PR
01
—
1164410619
NPI
PR
01
—
1184793374
NPI
PR
Enumeration date
07/21/2010
Last updated
02/21/2012
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