Organization
CENTRO PERIODONTAL DEL ESTE,CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL HERNANDEZ D.M.D. (PRESIDENT)
(787) 852-4475
Entity
Organization
Contact information
Practice address
HUMACAO MEDICAL PLAZA AVE. FONT MARTELO, OFFIC 104, HUMACAO, PR 00791
(787) 852-4475
(787) 285-0632
Mailing address
53 CALLE FONT MARTELO E, OFICINA 104, HUMACAO, PR 00791
(787) 852-4475
(787) 285-0632
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2009
PR
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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