IndividualActive
Mario Polo, DMD,MS
NPI 1639214018 · Orthodontics and Dentofacial Orthopedics Dentistry · San Juan, PR
Provider details
- NPI number
- 1639214018
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DMD,MS
- Sex
- Male
- Sole proprietor
- Yes
- License
- D0806 (PR)
Specialties & taxonomies
Dental Providers
Practice location
525 Ave Fd Roosevelt
702 La Torre De Plaza
San Juan, PR 00918-8001
Phone: (787) 754-7658
Fax: (787) 753-8415
Mailing address
525 Ave Fd Roosevelt
San Juan, PR 00918-8001
Registry dates
- Enumerated
- 2007-02-21
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.