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Individual

SELMA BASORA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
HC 1 BOX 25708, SAN GERMAN, PR 00683-9806
(787) 892-0585
(787) 892-0585
Mailing address
HC 1 BOX 25708, SAN GERMAN, PR 00683-9806
(787) 892-0585
(787) 892-0585

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2510
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2510
STATE LISENCE
PA
Enumeration date
03/08/2006
Last updated
07/08/2007
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