| Organization Name: | CLINICA DENTAL AGUIRRE DEL SUR |
| NPI Number: | 1750548954 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MANUEL CUBERO (DENTIST -OWNER) |
| Mailing Address: | Rd #3 Barbosa St #2 Aguirre |
| State: | PR US |
| Postal Code: | 00704 |
| Phone Number: | 7878532410 |
| Fax Number: | 7878530463 |
| NPI Enumeration Date: | 05/16/2008 |
| NPI Last Update Date: | 05/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 2393 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |