Individual
DR. CLYDE HENRY FASICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
29 WASHINGTON ST, SUITE 808 ASHFORD MEDICAL CENTER, SAN JUAN, PR 00907
(787) 725-4776
(787) 725-4776
Mailing address
ASHFORD MEDICAL CENTER, SUITE 808 #29 WASHINGTON ST, SAN JUAN, PR 00907
(787) 725-4776
(787) 725-4776
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1729
PR
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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