Provider Demographics
NPI:1487189171
Name:WISCOVITCH TURNEY, ANDRES GUSTAVO (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:GUSTAVO
Last Name:WISCOVITCH TURNEY
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13004
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-3004
Mailing Address - Country:US
Mailing Address - Phone:727-235-3912
Mailing Address - Fax:
Practice Address - Street 1:EDIF GUAYACAN
Practice Address - Street 2:202 CALLE JULIO CINTRON SUITE 221
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-520-7148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33891223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery