Provider Demographics
NPI:1982817789
Name:OFICINA DENTAL DR Y DRA SHEPLAN
Entity Type:Organization
Organization Name:OFICINA DENTAL DR Y DRA SHEPLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHEPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-844-3136
Mailing Address - Street 1:8169 CALLE CONCORDIA STE 404
Mailing Address - Street 2:COND SAN VICENTE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1566
Mailing Address - Country:US
Mailing Address - Phone:787-844-3136
Mailing Address - Fax:
Practice Address - Street 1:8169 CALLE CONCORDIA STE 404
Practice Address - Street 2:COND SAN VICENTE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1566
Practice Address - Country:US
Practice Address - Phone:787-844-3136
Practice Address - Fax:787-842-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty