Provider Demographics
NPI:1518018506
Name:YVR SERVICIOS DENTALES CSP
Entity Type:Organization
Organization Name:YVR SERVICIOS DENTALES CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-877-1701
Mailing Address - Street 1:469 CALLE CALETA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2286
Mailing Address - Country:US
Mailing Address - Phone:787-877-1701
Mailing Address - Fax:787-877-1701
Practice Address - Street 1:469 CALLE CALETA
Practice Address - Street 2:CALLE DON CHEMARY #86 MOCA PR
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2286
Practice Address - Country:US
Practice Address - Phone:787-877-1701
Practice Address - Fax:787-877-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1154364701OtherDENTIST