Provider Demographics
NPI:1356136261
Name:ITHAMAR CASTRO PIERLUISSI DENTAL LLC
Entity type:Organization
Organization Name:ITHAMAR CASTRO PIERLUISSI DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:ITHAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-783-6698
Mailing Address - Street 1:CAPARRA GALLERY
Mailing Address - Street 2:107 AVE ORTEGON STE 202
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-783-6698
Mailing Address - Fax:787-793-3105
Practice Address - Street 1:CAPARRA GALLERY
Practice Address - Street 2:107 AVE ORTEGON STE 202
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-783-6698
Practice Address - Fax:787-793-3105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental