Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 1608 | PR |
NPI | 1033114046 |
---|---|
Provider Name | Dr. Osvaldo Barnecet Lugo |
First Address | Caguas, PR 00725-6157 |
Second Address | Caguas, PR 00725-6157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 08/07/2007 |