Provider Demographics
NPI:1578977369
Name:OFICINA DENTAL DRA LAURA DEL FIERRO C LLC
Entity Type:Organization
Organization Name:OFICINA DENTAL DRA LAURA DEL FIERRO C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ALEJANDRA
Authorized Official - Last Name:DEL FIERRO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-887-3595
Mailing Address - Street 1:5302 CALLE CERRILLO
Mailing Address - Street 2:AA3 RIVER VALLEY TOWN PARK
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-887-3595
Mailing Address - Fax:888-988-1781
Practice Address - Street 1:CENTRO COMERCIAL VILLAS DE RIO GRANDE
Practice Address - Street 2:CALLE PIMENTEL PRIMER PISO
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-887-3595
Practice Address - Fax:787-888-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2748261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental