Provider Demographics
NPI:1598144156
Name:SLEEP APNEA DENTAL SOLUTIONS OF PUERTO RICO PSC
Entity Type:Organization
Organization Name:SLEEP APNEA DENTAL SOLUTIONS OF PUERTO RICO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARCIA AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:787-851-2365
Mailing Address - Street 1:100 AVE. PEDRO ALBIZU CAMPOS
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3339
Mailing Address - Country:US
Mailing Address - Phone:787-851-2365
Mailing Address - Fax:
Practice Address - Street 1:100 AVE. PEDRO ALBIZU CAMPOS
Practice Address - Street 2:CENTRO PROFESIONAL BORINQUEN; OFFICE C-4
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-3339
Practice Address - Country:US
Practice Address - Phone:787-851-2365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7467280001Medicare NSC