Provider Demographics
NPI:1548987811
Name:JOSE A ITURREGUI DDS MS LLC
Entity type:Organization
Organization Name:JOSE A ITURREGUI DDS MS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ITURREGUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:407-314-1985
Mailing Address - Street 1:90 CANDELERO DRIVE
Mailing Address - Street 2:VILLA 122
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-7908
Mailing Address - Country:US
Mailing Address - Phone:407-314-1985
Mailing Address - Fax:
Practice Address - Street 1:CARR. 111, KM 17.9, BO. GUATEMALA
Practice Address - Street 2:EDIFICIO VISTA VISION
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-280-5600
Practice Address - Fax:787-280-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental