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Organization

SAN JUAN ENDODONTICS PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSE AGUSTIN MEDINA DMD (CEO)
(787) 765-7248
Entity
Organization

Contact information

Practice address
1738 CALLE AMARILLO, SUITE 207-B (BOX 16), SAN JUAN, PR 00926-3072
(787) 765-7248
Mailing address
1738 AMARILLO ST., BOX 16, SAN JUAN, PR 00926
(787) 765-7248

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2008
PR

Other

Enumeration date
10/27/2014
Last updated
10/27/2014
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