Provider Demographics
NPI:1598738486
Name:SONRISAS DENTAL CARE
Entity Type:Organization
Organization Name:SONRISAS DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-798-8878
Mailing Address - Street 1:28 CALLE PALMER
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6334
Mailing Address - Country:US
Mailing Address - Phone:787-798-8888
Mailing Address - Fax:787-779-2707
Practice Address - Street 1:28 CALLE PALMER
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6334
Practice Address - Country:US
Practice Address - Phone:787-798-8888
Practice Address - Fax:787-779-2707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherSSS PROVIDER ID