Organization
CLINICA DENTAL JIREH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE BERRIOS (ADMINISTRATOR)
(787) 786-4133
Entity
Organization
Contact information
Practice address
R14 COLINA LA MARQUESA, URB LAS COLINAS, TOA BAJA, PR 00949-4930
(787) 786-4133
Mailing address
PO BOX 1435, SABANA SECA, PR 00952
(787) 786-4133
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2029
PR
1223G0001X
General Practice Dentistry
Primary
2155
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821038191
DR ANGEL I HERNANDEZ PEREZ
PR
01
—
1902947294
DRA LIVIA M CRUZ FELIX
PR
Enumeration date
04/12/2011
Last updated
04/12/2011
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