Provider Demographics
NPI:1013063668
Name:PEDRO RODRIGUEZ SOLA DENTISTAS CSP
Entity Type:Organization
Organization Name:PEDRO RODRIGUEZ SOLA DENTISTAS CSP
Other - Org Name:CAPARRA GALLERY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:BENITO
Authorized Official - Last Name:RODRIGUEZ SOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-273-6810
Mailing Address - Street 1:CAPARRA GALLERY PLAZA, SUITE 306
Mailing Address - Street 2:107 AVE GONZALEZ GIUSTI
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-273-6810
Mailing Address - Fax:787-273-0521
Practice Address - Street 1:CAPARRA GALLERY PLAZA, SUITE 306
Practice Address - Street 2:107 AVE GONZALEZ GIUSTI
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-273-6810
Practice Address - Fax:787-273-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty