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Individual

DR. MARIO FALLETTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
#62 DR VEVE, SAN GERMAN, PR 00683
(787) 892-3672
(787) 892-6909
Mailing address
PO BOX 124, SAN GERMAN, PR 00683-0124
(787) 892-3672
(787) 892-6909

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
PR2369
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041980
CRUZ AZUL
PR
01
1192
IMC
PR
01
206286
PREFERED HEALTH
PR
01
2369
LICENCIA DENTAL
PR
01
42352
SSS
PR
01
6230072
HUMANA
PR
01
70141
PREFERED MEDICARE CHOICE
PR
Enumeration date
10/02/2006
Last updated
07/08/2007
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