Individual
DR. JOSE GUSTAVO WISCOVITCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S
Contact information
Practice address
AVE. PEDRO ALBIZU CAMPOS # 2022, AGUADILLA, PR 00603
(787) 891-9155
(787) 882-8050
Mailing address
P.O. BOX 8053 MARINA STATION, MAYAQUEZ, PR 00681
(787) 891-9155
(787) 882-8050
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1385
PR
1223P0106X
Oral and Maxillofacial Pathology Dentistry
1385
PR
Other
Enumeration date
10/07/2005
Last updated
06/04/2013
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