Provider Demographics
NPI:1215364898
Name:DIGITAL DENTISTRY GROUP C.S.P.
Entity Type:Organization
Organization Name:DIGITAL DENTISTRY GROUP C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-616-8557
Mailing Address - Street 1:CALLE 1 AX-2, PRADERA NORTE
Mailing Address - Street 2:LEVITTOWN
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950
Mailing Address - Country:US
Mailing Address - Phone:787-795-3427
Mailing Address - Fax:787-795-5843
Practice Address - Street 1:CALLE 1 AX-2, PRADERA NORTE
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00950
Practice Address - Country:US
Practice Address - Phone:787-795-3427
Practice Address - Fax:787-795-5843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2481122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty