Provider Demographics
NPI:1699414508
Name:CN DENTAL LLC
Entity Type:Organization
Organization Name:CN DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UBALDINO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ DE ARELLANO PONCE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-375-4425
Mailing Address - Street 1:CONDOMINIO LA CIMA 404A
Mailing Address - Street 2:URB PASEO LOS ROBLES
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-464-4142
Mailing Address - Fax:
Practice Address - Street 1:MENDEZ VIGO OESTE
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-464-4142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty