Provider Demographics
NPI:1952674939
Name:GRUPO DENTAL DR JOSE M FELIU, PSC
Entity Type:Organization
Organization Name:GRUPO DENTAL DR JOSE M FELIU, PSC
Other - Org Name:GRUPO DENTAL DR JOSE M FELIU, PSC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELIU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-738-5573
Mailing Address - Street 1:531 AVE ANTONIO R BARCELO
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-4189
Mailing Address - Country:US
Mailing Address - Phone:787-738-5573
Mailing Address - Fax:787-535-5575
Practice Address - Street 1:531 AVE ANTONIO R BARCELO
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4189
Practice Address - Country:US
Practice Address - Phone:787-738-5573
Practice Address - Fax:787-535-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21971223G0001X
PR09451223G0001X
PR22411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty