| NPI | 1720483191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN L MOLINA Director 787-765-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |