Provider Demographics
NPI:1043392053
Name:VECCHINI, MARCOS F (DMD, MSCD)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:F
Last Name:VECCHINI
Suffix:
Gender:M
Credentials:DMD, MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 AVE FD ROOSEVELT
Mailing Address - Street 2:SUITE 615 LA TORRE DE PLAZA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-8001
Mailing Address - Country:US
Mailing Address - Phone:787-767-1233
Mailing Address - Fax:787-753-0299
Practice Address - Street 1:525 AVE F D ROOSEVELT
Practice Address - Street 2:SUITE 615 LA TORRE DE PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-767-1233
Practice Address - Fax:787-753-0299
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8541223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR854OtherDENTAL LICENCE
PRAV7285504OtherDEA LICENCE