Provider Demographics
NPI:1386206373
Name:DRA. JENNIFER LITHGOW CAMPOS P.S.C.
Entity Type:Organization
Organization Name:DRA. JENNIFER LITHGOW CAMPOS P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LITHGOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-519-5701
Mailing Address - Street 1:221 CALLE DUKE URBANIZACION UNIVERSITY GARDENS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-519-5701
Mailing Address - Fax:
Practice Address - Street 1:CARR 493 BO CARRIZALES
Practice Address - Street 2:MEDICAL & PROFESSIONAL PLAZA SUITE 133
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-817-8030
Practice Address - Fax:787-880-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty