Bajalu, LLC

NPI #1144813551 in San Antonio, Puerto Rico

Provider Information

NPI Number: 1144813551
Entity Type: Organization
Organization Name: Bajalu, LLC
Primary Specialty: Dentist - Oral and Maxillofacial Surgery
Enumeration Date: Feb 17, 2021
Last Updated: Mar 4, 2021

Practice Location

Address: 1005 AVE GENERAL RAMEY STE 1
City: San Antonio
State: Puerto Rico
ZIP Code: 00690-1109
Phone: (787) 510-0912

Authorized Official

Name: DR. RAFAEL A. GAVILANES, DMD
Title: VICE-PRESIDENTE
Phone: (787) 510-0912

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X	Primary

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