Provider Demographics
NPI:1114048063
Name:CLINICA DENTAL DE LA FAMILIA
Entity Type:Organization
Organization Name:CLINICA DENTAL DE LA FAMILIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-845-0892
Mailing Address - Street 1:PMB 210
Mailing Address - Street 2:PO BOX 4000
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757
Mailing Address - Country:US
Mailing Address - Phone:787-845-0892
Mailing Address - Fax:
Practice Address - Street 1:STREET 153 BO. JAUCA
Practice Address - Street 2:PLAZA SANTA ISABEL SUITE 13
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-845-0892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2575261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental