Organization
OFICINA DENTAL FAMILIAR CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRMA L GONZALEZ DMD (PRESIDENT)
(787) 878-2805
Entity
Organization
Contact information
Practice address
OFICINA DENTAL FAMILIAR 1254 SANTANA, ARECIBO, PR 00612
(787) 878-2805
(787) 878-3887
Mailing address
PO BOX 1235, ARECIBO, PR 00613
(787) 878-2805
(787) 878-3887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2487
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043021
BCBS
PR
01
—
206473
PREFERRED HEALTH
PR
01
—
42470
SSS
PR
01
—
6120160
HUMANA
PR
01
—
70584
PREFERRED MEDICAL CHOICE
PR
Enumeration date
10/02/2006
Last updated
08/22/2020
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