Provider Demographics
NPI:1720291685
Name:PEREZ MOLL, JOSE F (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:F
Last Name:PEREZ MOLL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 AVE BETANCES
Mailing Address - Street 2:HERMANAS DAVILA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5159
Mailing Address - Country:US
Mailing Address - Phone:787-798-4083
Mailing Address - Fax:
Practice Address - Street 1:191 AVE BETANCES
Practice Address - Street 2:HERMANAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5159
Practice Address - Country:US
Practice Address - Phone:787-798-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics