Provider Demographics
NPI:1093693673
Name:CLINICA DENTAL MARBELLA, LLC
Entity type:Organization
Organization Name:CLINICA DENTAL MARBELLA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAYANISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAN BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-501-8992
Mailing Address - Street 1:URB EL ROSARIO 2 CALLE 5 R 21
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PLAZA LAS VEGAS MALL, CARR. #2 KM 39.1
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-5342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental