Provider Demographics
NPI:1447219530
Name:OFICINA DENTAL FEIJOO
Entity Type:Organization
Organization Name:OFICINA DENTAL FEIJOO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-869-0057
Mailing Address - Street 1:HC 7 1 BOX 3512
Mailing Address - Street 2:BO. CEDRO ARRIBA
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719
Mailing Address - Country:US
Mailing Address - Phone:787-869-0057
Mailing Address - Fax:787-869-0057
Practice Address - Street 1:HC 71 BOX 3512
Practice Address - Street 2:BO. CEDRO ARRIBA
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-9800
Practice Address - Country:US
Practice Address - Phone:787-869-0057
Practice Address - Fax:787-869-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty