Provider Demographics
NPI:1619864790
Name:GPA SURGICAL PR LLC
Entity type:Organization
Organization Name:GPA SURGICAL PR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL & MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:PUIG ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:917-808-6093
Mailing Address - Street 1:1 CALLE INGA COND COSTAMAR
Mailing Address - Street 2:6D
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00913
Mailing Address - Country:US
Mailing Address - Phone:917-808-6093
Mailing Address - Fax:
Practice Address - Street 1:1005 AVE GENERAL RAMEY # 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:PR
Practice Address - Zip Code:00690-1109
Practice Address - Country:US
Practice Address - Phone:939-291-0642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty