Individual
DR. ELLIS I HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1212 CALLE CADIZ, SAN JUAN, PR 00920-3841
(787) 781-3187
(787) 782-5547
Mailing address
PO BOX 193392, SAN JUAN, PR 00919-3392
(787) 781-3187
(787) 782-5547
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1352
PR
Other
Enumeration date
06/29/2005
Last updated
07/18/2012
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