Organization
PERIO DEL SUR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIEGO E RODES DDS (PRESIDENT)
(787) 219-9032
Entity
Organization
Contact information
Practice address
909 AVE TITO CASTRO STE 810, PONCE, PR 00716-4725
(787) 219-9032
Mailing address
PO BOX 3171, MAYAGUEZ, PR 00681-3171
(787) 219-9032
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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