Dietrich Dental P.S.C
Health Maintenance Organization in Guaynabo, PR. Organization (NPI-2).
NPI number1689819260
StatusActive
Last updated in NPPESDec 10, 2008
Details
- NPI
- 1689819260
- Entity type
- Organization (NPI-2)
- Legal business name
- Dietrich Dental P.S.C
- Organization subpart
- No
- Enumeration date
- Dec 10, 2008
- Last updated
- Dec 10, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302R00000X | Health Maintenance Organization | 2179 | PR | Yes |
Practice location
La Galeria Suchville 97 Carr 2Ste 208
Guaynabo, PR 00966
Phone 787-705-5063 · Fax 787-705-5065
Mailing address
La Galeria Suchville 97Carr. 2 Suite 208
Guaynabo, PR 00966
Phone 787-705-5063 · Fax 787-705-5065
Authorized official
Rene Dietrich-Trigo
Dentist
7877055063
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