| Organization Name: | SONRISAS RADIANTES DENTAL CLINIC(CSP) |
| NPI Number: | 1003947284 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MAGALY MARRERO (OFFICE MANAGER) |
| Mailing Address: | Centro Gran Caribe Suite 209 Vega Alta |
| State: | PR US |
| Postal Code: | 006926711 |
| Phone Number: | 7878836446 |
| Fax Number: | 7878836058 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 01/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |