Provider Demographics
NPI:1578646147
Name:TROCHE, ENID HORTENSIA (DMD)
Entity Type:Individual
Prefix:
First Name:ENID
Middle Name:HORTENSIA
Last Name:TROCHE
Suffix:
Gender:F
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:CALLE BOQUERON #28
Mailing Address - Street 2:VILLAS DE LA PLAYA
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-807-7671
Mailing Address - Fax:787-807-7671
Practice Address - Street 1:CALLE JOSE JULIAN ACOSTA #42
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-807-7671
Practice Address - Fax:787-807-7671
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice