Provider Demographics
NPI:1831802263
Name:VIRUET DENTISTRY LLC
Entity type:Organization
Organization Name:VIRUET DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES VIRUET
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:239-834-5891
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0719
Mailing Address - Country:US
Mailing Address - Phone:239-834-5891
Mailing Address - Fax:
Practice Address - Street 1:CARR #2 KM 55.5 SECTOR PALENQUE
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-846-0352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental