Provider Demographics
NPI:1467090498
Name:EXCELENCIA DENTAL, PSC
Entity Type:Organization
Organization Name:EXCELENCIA DENTAL, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIGAU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-852-6852
Mailing Address - Street 1:PO BOX 3596
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-6596
Mailing Address - Country:US
Mailing Address - Phone:787-852-6852
Mailing Address - Fax:787-852-0031
Practice Address - Street 1:61 CALLE ANTONIO LOPEZ S STE 1
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4262
Practice Address - Country:US
Practice Address - Phone:787-852-6852
Practice Address - Fax:787-852-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty