Provider Demographics
NPI:1649607417
Name:DENTAL WORLD CLINIC L.L.C.
Entity type:Organization
Organization Name:DENTAL WORLD CLINIC L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIL
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-206-2839
Mailing Address - Street 1:15 CALLE DR RUFO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3741
Mailing Address - Country:US
Mailing Address - Phone:787-747-1035
Mailing Address - Fax:787-747-1035
Practice Address - Street 1:15 CALLE DR RUFO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3741
Practice Address - Country:US
Practice Address - Phone:787-747-1035
Practice Address - Fax:787-747-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty