Individual
DR. JOSE ANTONIO SURIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
400 ROOSEVELT AVE, SUITE 502, SAN JUAN, PR 00918
(787) 756-5252
Mailing address
PO BOX 9022045, SAN JUAN, PR 00902-2045
(787) 724-7112
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
626
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
626
STATE LICENCE
PR
Enumeration date
08/30/2006
Last updated
07/08/2007
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