Provider Demographics
NPI:1699016295
Name:LMA COSMETIC, ORAL AND MAXILLOFACIAL SURGERY SERVICES, PSC
Entity Type:Organization
Organization Name:LMA COSMETIC, ORAL AND MAXILLOFACIAL SURGERY SERVICES, PSC
Other - Org Name:LMA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:AROCHO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-346-3844
Mailing Address - Street 1:LAS CATALINAS MALL
Mailing Address - Street 2:CARIBBEAN CINEMAS SUITE 205
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5200
Mailing Address - Country:US
Mailing Address - Phone:787-961-8090
Mailing Address - Fax:787-961-8099
Practice Address - Street 1:LAS CATALINAS MALL
Practice Address - Street 2:CARIBBEAN CINEMAS SUITE 205
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5200
Practice Address - Country:US
Practice Address - Phone:787-961-8090
Practice Address - Fax:787-961-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2673261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery