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Organization

WEST SIDE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ABIMELEC PORTALATIN PEREZ (OWNER)
(787) 718-2284
Entity
Organization

Contact information

Practice address
CARR 459 KM 1.8 INT, AGUADILLA, PR 00603
(787) 718-2284
Mailing address
PO BOX 310, SAN ANTONIO, PR 00690-0310
(787) 718-2284

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
06/03/2022
Last updated
09/08/2022
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  • Eligibility checks
  • EDI platform