Provider Demographics
NPI:1013192244
Name:CLINICA DENTAL DRA. ZOILA I. BAEZ ORTIZ
Entity Type:Organization
Organization Name:CLINICA DENTAL DRA. ZOILA I. BAEZ ORTIZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZOILA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-787-7540
Mailing Address - Street 1:90 AVE. RIO HONDO
Mailing Address - Street 2:PMB SUITE 418
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-0000
Mailing Address - Country:US
Mailing Address - Phone:787-787-7540
Mailing Address - Fax:787-787-7540
Practice Address - Street 1:AVE. NORTH MAIN BLOQ. 10 #5
Practice Address - Street 2:URB. SIERRA BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-0000
Practice Address - Country:US
Practice Address - Phone:787-787-7540
Practice Address - Fax:787-787-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental