Provider Demographics
NPI:1942401526
Name:PAULA C SERVICIOS DENTAES, CSP
Entity type:Organization
Organization Name:PAULA C SERVICIOS DENTAES, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATTEI-MOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:787-899-4925
Mailing Address - Street 1:PO BOX 1521
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-1521
Mailing Address - Country:US
Mailing Address - Phone:787-899-4925
Mailing Address - Fax:
Practice Address - Street 1:INFANTERIA SUR STREET #80
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-899-4925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR021521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty