Individual
DR. LUIS ALBERTO DOMINGUEZ CARRAZQUILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
CALLE PALMER SUR #24, GUAYAMA, PR 00784-7610
(787) 866-3631
(787) 866-8690
Mailing address
PO BOX 623, GUAYAMA, PR 00785-0623
(787) 866-3631
(787) 866-8690
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1099
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1099
MENONITA
PR
01
—
26016
AMERICAN HEALTH
PR
01
—
4-1072
TRIPLE SSS
PR
01
—
40624
CRUZ AZUL
PR
01
—
6540025
HUMANA
PR
01
—
8634
IMC
PR
Enumeration date
07/07/2005
Last updated
07/08/2007
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