Organization
SANDOVAL DENTAL SERVICES, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN SANDOVAL D.M.D. (PRESIDENT)
(787) 798-6227
Entity
Organization
Contact information
Practice address
AQ-34 AVE. LAUREL, URB. SANTA JUANITA, BAYAMON, PR 00956
(787) 798-6227
(787) 785-9054
Mailing address
PO BOX 3189, BAYAMON, PR 00960-3189
(787) 798-6227
(787) 785-9054
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2002
PR
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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