Provider Demographics
NPI:1467588038
Name:OFICINA DENTAL DRA. MICHELLE RECIO PSC
Entity Type:Organization
Organization Name:OFICINA DENTAL DRA. MICHELLE RECIO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RECIO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-824-7293
Mailing Address - Street 1:6300 AVE ISLA VERDE
Mailing Address - Street 2:COND. LA MANCHA APT. 212
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-7153
Mailing Address - Country:US
Mailing Address - Phone:787-824-7293
Mailing Address - Fax:787-824-7293
Practice Address - Street 1:8 CALLE COLON PACHECO
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-3344
Practice Address - Country:US
Practice Address - Phone:787-824-7293
Practice Address - Fax:787-824-7293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2332261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental