Provider Demographics
NPI:1194228072
Name:THE DENTAL SOLUTIONS GROUP LLC
Entity Type:Organization
Organization Name:THE DENTAL SOLUTIONS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:HIRAM
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-753-5055
Mailing Address - Street 1:735 AVE PONCE DE LEON STE 510
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-5027
Mailing Address - Country:US
Mailing Address - Phone:787-753-5055
Mailing Address - Fax:
Practice Address - Street 1:AVE FERNANDEZ JUNCOS ESQ MOLINILLO
Practice Address - Street 2:PISO 4
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00988
Practice Address - Country:US
Practice Address - Phone:787-753-5085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty