| NPI | 1295042240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN SANDOVAL President 787-798-6227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 2002) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-10 |