Provider Demographics
NPI:1184210940
Name:CARE DENTAL LLC
Entity Type:Organization
Organization Name:CARE DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:MALDONADO PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-647-5699
Mailing Address - Street 1:1710 CALLE SANTA BRIGIDA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4239
Mailing Address - Country:US
Mailing Address - Phone:787-647-5699
Mailing Address - Fax:
Practice Address - Street 1:F14 AVE DEGETAU
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5839
Practice Address - Country:US
Practice Address - Phone:787-647-5699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty