Provider Demographics
NPI:1528306438
Name:FREI DENTAL PSC
Entity type:Organization
Organization Name:FREI DENTAL PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-595-4563
Mailing Address - Street 1:P.O. BOX 1555
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785
Mailing Address - Country:US
Mailing Address - Phone:787-866-3777
Mailing Address - Fax:787-866-5106
Practice Address - Street 1:86 SOUTH ASHFORD STREET
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785
Practice Address - Country:US
Practice Address - Phone:787-866-3777
Practice Address - Fax:787-866-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty