Provider Demographics
NPI:1336575349
Name:DUARTE DENTAL CARE,LLC
Entity Type:Organization
Organization Name:DUARTE DENTAL CARE,LLC
Other - Org Name:DUARTE DENTAL CARE ,LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DIAZ
Authorized Official - Middle Name:RODRIGUEZ
Authorized Official - Last Name:ERIKA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-487-5332
Mailing Address - Street 1:229 CALLE DUARTE
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3631
Mailing Address - Country:US
Mailing Address - Phone:787-630-8288
Mailing Address - Fax:787-651-6683
Practice Address - Street 1:229 CALLE DUARTE
Practice Address - Street 2:SUITE 5B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3631
Practice Address - Country:US
Practice Address - Phone:787-630-8288
Practice Address - Fax:787-651-6683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty