Organization
PRO ESTHETIC DENTAL LLC
Active
Other names
Pro Esthetic Dental LLC
Organization subpart
No
Provider details
NPI number
Authorized official
NADYAN VARGAS DMD (DMD)
(787) 265-3683
Entity
Organization
Contact information
Practice address
114 CALLE DE LA CANDELARIA W STE 107, MAYAGUEZ, PR 00680
(787) 265-3683
Mailing address
114 CALLE DE LA CANDELARIA W STE 107, MAYAGUEZ, PR 00680
(787) 265-3683
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0700X
Prosthodontics
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990219417
—
PR
Enumeration date
11/24/2021
Last updated
11/24/2021
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