Provider Demographics
NPI:1770234429
Name:ZULLY RUBI DENTAL LLC
Entity Type:Organization
Organization Name:ZULLY RUBI DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZULLY
Authorized Official - Middle Name:R
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-361-5380
Mailing Address - Street 1:144 HACIENDA DE LA BAUME
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-9706
Mailing Address - Country:US
Mailing Address - Phone:787-636-3300
Mailing Address - Fax:
Practice Address - Street 1:EDIF POLICLINICA BELLA VISTA
Practice Address - Street 2:770 AVE HOSTOS SUITE 203
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-636-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty