Provider Demographics
NPI:1235284480
Name:SERVICIOS DE SALUD ORAL, CSP
Entity Type:Organization
Organization Name:SERVICIOS DE SALUD ORAL, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION'S PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:1787-727-8960
Mailing Address - Street 1:1225 CALLE MARGINAL VILLAMAR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:178-772-7896
Mailing Address - Fax:178-772-6080
Practice Address - Street 1:1225 CALLE MARGINAL VILLAMAR
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-727-8960
Practice Address - Fax:787-726-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty