Provider Demographics
NPI:1679010755
Name:CARIBE DENTAL GALLERY
Entity Type:Organization
Organization Name:CARIBE DENTAL GALLERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ECHANDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:787-883-6560
Mailing Address - Street 1:SUITE 214 CARRETERA #2 KM 29.7
Mailing Address - Street 2:CENTRO GRAN CARIBE
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:US
Mailing Address - Phone:787-883-6560
Mailing Address - Fax:787-270-6286
Practice Address - Street 1:SUITE 208 CARRETERA #2 KM 29.7
Practice Address - Street 2:CENTRO GRAN CARIBE
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-6560
Practice Address - Fax:787-270-6286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental