Organization
PALM TREE LLC
Active
Other names
Dededo Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELIAS ABULENCIA (GENERAL MANAGER)
(671) 788-1706
Entity
Organization
Contact information
Practice address
144 KAYEN CHANDO STE 101, DEDEDO, GU 96929-4906
(671) 637-4867
Mailing address
144 KAYEN CHANDO STE 101, DEDEDO, GU 96929-4906
(671) 637-4867
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184990905
—
GU
Enumeration date
08/18/2025
Last updated
08/18/2025
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