Provider Demographics
NPI:1750548954
Name:CLINICA DENTAL AGUIRRE DEL SUR
Entity type:Organization
Organization Name:CLINICA DENTAL AGUIRRE DEL SUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST -OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CUBERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:787-853-2410
Mailing Address - Street 1:PO BOX 1499
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1499
Mailing Address - Country:US
Mailing Address - Phone:787-853-2410
Mailing Address - Fax:
Practice Address - Street 1:RD #3 BARBOSA ST #2
Practice Address - Street 2:
Practice Address - City:AGUIRRE
Practice Address - State:PR
Practice Address - Zip Code:00704
Practice Address - Country:US
Practice Address - Phone:787-853-2410
Practice Address - Fax:787-853-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2393261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental