Provider Demographics
NPI:1528147121
Name:GARCIA-VINAS, MANUEL O (DMD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:O
Last Name:GARCIA-VINAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A-12 VILLA DEL CAPITAN
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-831-3587
Mailing Address - Fax:787-267-1973
Practice Address - Street 1:70 CALLE COMERCIO
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3530
Practice Address - Country:US
Practice Address - Phone:787-267-1974
Practice Address - Fax:787-267-1973
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics