Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 1678 | PR |
NPI | 1063435519 |
---|---|
Provider Name | Dr. Pedro J Andujar |
First Address | Gurabo, PR 00778 |
Second Address | Guayama, PR 00784 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |