Provider Demographics
NPI:1366242497
Name:AVR PROSTHODONTICS LLC
Entity type:Organization
Organization Name:AVR PROSTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:VAZQUEZ RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-646-2997
Mailing Address - Street 1:URB SAN FRANCISCO 1661 CALLE PLAYERA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-646-2997
Mailing Address - Fax:
Practice Address - Street 1:A20 CALLE 13
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4553
Practice Address - Country:US
Practice Address - Phone:787-799-1170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1720587983Medicaid