Provider Demographics
NPI:1245587377
Name:CLINICA DENTAL DOZ
Entity Type:Organization
Organization Name:CLINICA DENTAL DOZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-727-3550
Mailing Address - Street 1:1075 CALLE MARGINAL VILLAMAR EXT. VILLAMAR
Mailing Address - Street 2:ISLA VERDE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6346
Mailing Address - Country:US
Mailing Address - Phone:787-727-3550
Mailing Address - Fax:787-728-6855
Practice Address - Street 1:1075 CALLE MARGINAL VILLAMAR EXT. VILLAMAR
Practice Address - Street 2:ISLA VERDE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6346
Practice Address - Country:US
Practice Address - Phone:787-727-3550
Practice Address - Fax:787-728-6855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty