Individual
DR. JOSE DISLA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
185 CALLE DELBREY, SANTURCE, PR 00911
(787) 725-1703
(787) 724-4622
Mailing address
185 CALLE DELBREY, SANTURCE, PR 00911
(787) 725-1703
(787) 724-4622
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1978
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041560
CRUZ AZUL
PR
01
—
3856
INTERNATIONAL MEDICAL CAR
PR
Enumeration date
11/07/2006
Last updated
07/08/2007
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