Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 2072 | PR |
NPI | 1164450094 |
---|---|
Provider Name | Dr. Jose Angel Alvarez |
First Address | Ponce, PR 00717-2113 |
Second Address | Ponce, PR 00717-2113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |