| NPI | 1174521827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERIBERTO J MONTALVO President 787-787-2384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PR 1159) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 1258) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-08-22 |