Organization
IVANCA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIARA NAHIR OTERO D.M.D. (DENTIST)
(787) 855-3996
Entity
Organization
Contact information
Practice address
38-B CALLE BETANCES, VEGA BAJA, PR 00693-4453
(787) 855-3996
(787) 855-3996
Mailing address
38-B CALLE BETANCES, VEGA BAJA, PR 00693-4453
(787) 855-3996
(787) 855-3996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2777
PR
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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