Provider Demographics
NPI:1548232580
Name:PICON, FRANCIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:
Last Name:PICON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 AVE DE DIEGO STE 112-2
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6322
Mailing Address - Country:US
Mailing Address - Phone:787-461-6516
Mailing Address - Fax:
Practice Address - Street 1:42 CALLE FARAGAN
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2588
Practice Address - Country:US
Practice Address - Phone:787-461-6516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20361223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
041633OtherLA CRUZ AZUL DE PUERTO RI
DP02036OtherPLAN DE SALUD UIA
41886PIOtherSEGUROS DE SERVICIOS DE S
831925OtherUNITED CONCORDIA
9180189OtherHUMANA INSURANCE
26191OtherAMERICAN HEALTH
9180189OtherHUMANA REFORMA