Provider Demographics
NPI:1366783920
Name:BAYAMON ENDODONTICS
Entity type:Organization
Organization Name:BAYAMON ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:RODRIGUEZ RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-963-0666
Mailing Address - Street 1:1995 CARR. #2 SUITE 1808
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-1808
Mailing Address - Country:US
Mailing Address - Phone:787-963-0666
Mailing Address - Fax:787-963-0451
Practice Address - Street 1:METRO MEDICAL CENTER TORRE A SUITE 808
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-963-0601
Practice Address - Fax:787-963-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2823261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental