Provider Demographics
NPI:1841921954
Name:RDO DIGITEC LLC
Entity type:Organization
Organization Name:RDO DIGITEC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTISTA
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:DAMASO
Authorized Official - Last Name:ORTIZ ESCALERA
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:787-825-0222
Mailing Address - Street 1:43 CALLE BALDORIOTY STE 3
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-3120
Mailing Address - Country:US
Mailing Address - Phone:787-825-0222
Mailing Address - Fax:787-471-7358
Practice Address - Street 1:43 CALLE BALDORIOTY STE 3
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-3120
Practice Address - Country:US
Practice Address - Phone:787-825-0222
Practice Address - Fax:787-471-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038649500Medicaid