Organization
CAVITY REPAIR LLC
Active
Parent organization
CAVITY REPAIR LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAVITY REPAIR LLC
Authorized official
MR. EDWIN E LAFONTAINE DMD (DENTIST)
(787) 515-7036
Entity
Organization
Contact information
Practice address
PALMAS PLANTATION, 122, HUMACAO, PR 00791-6022
(787) 515-7036
(787) 885-0560
Mailing address
122 PALMAS PLANTATION, TEE STREET, HUMACAO, PR 00791-6022
(787) 515-7136
(787) 885-0560
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2080
PR
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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