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Individual

DR. EMMANUEL JOSE AMUNDARAY DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
735 AVE PONCE DE LEON STE 510, SAN JUAN, PR 00917-5027
(787) 250-5055
Mailing address
12 ALBOLOTE AVENUE, CONDO. CHALETS DEL PARQUE, APT 2A3 MAILBOX #136, GUAYNABO, PR 00969
(787) 565-5272

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
30025184
OH
122300000X
Dentist
Primary
3420
PR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
060843
NY

Other

Enumeration date
05/16/2016
Last updated
02/28/2023
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