Provider Demographics
NPI:1083024137
Name:JO AN SANCHEZ CSP
Entity Type:Organization
Organization Name:JO AN SANCHEZ CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE/TESORERO
Authorized Official - Prefix:DR
Authorized Official - First Name:JO AN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-505-3903
Mailing Address - Street 1:PLAZA NORESTE SHOPPING CENTER SUITE 22
Mailing Address - Street 2:URB VILLAS DE LOIZA
Mailing Address - City:LOIZA
Mailing Address - State:PR
Mailing Address - Zip Code:00772
Mailing Address - Country:US
Mailing Address - Phone:787-256-0225
Mailing Address - Fax:787-876-2855
Practice Address - Street 1:PLAZA NORESTE SHOPPING CENTER 22
Practice Address - Street 2:URB VILLAS DE LOIZA
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-256-0225
Practice Address - Fax:787-876-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2403122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty