Provider Demographics
NPI:1851446488
Name:FRANCO MAL, JOSE L (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:L
Last Name:FRANCO MAL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7531
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7531
Mailing Address - Country:US
Mailing Address - Phone:787-922-7453
Mailing Address - Fax:787-840-0475
Practice Address - Street 1:104 CALLE REINA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3683
Practice Address - Country:US
Practice Address - Phone:787-842-0366
Practice Address - Fax:787-840-0475
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice