Provider Demographics
NPI:1467875112
Name:DENTISTRY 4 ALL, PSC
Entity Type:Organization
Organization Name:DENTISTRY 4 ALL, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-242-5942
Mailing Address - Street 1:PO BOX 375419
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-5419
Mailing Address - Country:US
Mailing Address - Phone:787-242-5942
Mailing Address - Fax:
Practice Address - Street 1:TERRA DEL MONTE CALLE 1 #85
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-242-5942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28551223G0001X
PR28701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1720394471Medicaid
PR1619272747Medicaid