Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 0491 | PR |
NPI | 1245237197 |
---|---|
Provider Name | Dr. Benigno A Caban Gomez |
First Address | Arecibo, PR 00613-0375 |
Second Address | Arecibo, PR 00612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 16/12/2008 |