Provider Demographics
NPI:1790817773
Name:OFICINA DENTAL DRA AMNERIS VERA NEGRON, CSP
Entity Type:Organization
Organization Name:OFICINA DENTAL DRA AMNERIS VERA NEGRON, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMNERIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-734-1330
Mailing Address - Street 1:PO BOX 2411
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-2411
Mailing Address - Country:US
Mailing Address - Phone:787-734-1330
Mailing Address - Fax:787-734-1330
Practice Address - Street 1:18 CALLE ESCUTE
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-3415
Practice Address - Country:US
Practice Address - Phone:787-734-1330
Practice Address - Fax:787-734-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty