Organization
DENTO-PED, CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SELMA BASORA DMD (PRESIDENT/SECRETARY)
(787) 892-0585
Entity
Organization
Contact information
Practice address
HC 1 BOX 25708, SAN GERMAN, PR 00683-9806
(787) 892-0585
(787) 892-0585
Mailing address
HC 1 BOX 25708, SAN GERMAN, PR 00683-9806
(787) 892-0585
(787) 892-0585
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2510
PR
Other
Enumeration date
03/08/2006
Last updated
08/22/2020
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