Organization
CLINICA DENTAL RAFAEL J.GOMEZ MATTA PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL JOSE GOMEZ DMD (PRESIDENT)
(787) 735-3500
Entity
Organization
Contact information
Practice address
57 CALLE DEGETAU N, AIBONITO, PR 00705-3613
(787) 735-3500
Mailing address
PO BOX 2124, AIBONITO, PR 00705-2124
(787) 735-3500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0721
PR
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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