Provider Demographics
NPI:1134274202
Name:DENTAL EXCELLENCE,PSC
Entity type:Organization
Organization Name:DENTAL EXCELLENCE,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BERDIEL TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-296-4000
Mailing Address - Street 1:239 AVE ARTERIAL HOSTOS
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1474
Mailing Address - Country:US
Mailing Address - Phone:787-296-4000
Mailing Address - Fax:787-296-3064
Practice Address - Street 1:239 AVE ARTERIAL HOSTOS
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1474
Practice Address - Country:US
Practice Address - Phone:787-296-4000
Practice Address - Fax:787-296-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25261223G0001X
PR25271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty