Orlando J Colon-Aviles, DDS

Individual provider Active NPI General Practice Dentistry · Moca, PR

NPI 1114023645 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1114023645
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2139 (PR)
Practice address
Road 110 KM 12.4
2ND Floor Colon Plaza Building
Moca, PR 00676
Phone
(787) 877-2500
Fax
(787) 877-2505
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2139PRMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2139 PR Yes

Addresses

Primary practice location

Road 110 KM 12.4
2ND Floor Colon Plaza Building
Moca, PR 00676

Mailing address

PO Box 1572
Moca, PR 00676-1572
Phone (787) 877-2500

Other identifiers

IdentifierTypeStateIssuer
2139OtherPRPLAN DE SERVICIOS DE SALU
6843OtherPRINTERNATIONAL MED CARD
206799OtherPRPREFERRED HEALTH
26258OtherPRAMERICAN HEALTH
70356OtherPRPREFERRED MEDICARE CHOICE
41986OtherPRSSS
041734OtherPRCRUZ AZUL

Other providers in Moca, PR

All providers in Moca, PR · General Practice Dentistry in Puerto Rico

Sources for this page

Verify at the official NPI Registry.