Organization
MPL MAXILLOFACIAL SURGERY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL PASTRANA (PRESIDENT)
(954) 232-5590
Entity
Organization
Contact information
Practice address
CARR 111 KM 18, BAHOMAMEY, SAN SEBASTIAN, PR 00685
(954) 232-5590
Mailing address
PO BOX 1678, SAN SEBASTIAN, PR 00685-1678
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2043
PR
Other
Enumeration date
04/11/2011
Last updated
06/01/2011
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