Provider Demographics
NPI:1942539697
Name:OFICINA BIOESTETICA DENTAL, CORP
Entity Type:Organization
Organization Name:OFICINA BIOESTETICA DENTAL, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:JIMENEZ COLON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-250-9589
Mailing Address - Street 1:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:SAINT JUST
Mailing Address - State:PR
Mailing Address - Zip Code:00978-0892
Mailing Address - Country:US
Mailing Address - Phone:787-763-8797
Mailing Address - Fax:787-250-9589
Practice Address - Street 1:CALLE LODI 601
Practice Address - Street 2:VILLA CAPRI
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-763-8797
Practice Address - Fax:787-250-9589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty