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Individual

ARIEL O JUSINO CORDOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
B12 CALLE 2, VILLA REAL, VEGA BAJA, PR 00693-5301
(787) 858-5200
Mailing address
B12 CALLE 2, VILLA REAL, VEGA BAJA, PR 00693-5301
(787) 858-5200

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1147
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41050
DENTAL PROVIDER
PR
Enumeration date
11/20/2006
Last updated
03/25/2016
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