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Organization
FUNCTIONAL FACIAL ORTHOPEDICS
Active
Organization
FUNCTIONAL FACIAL ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NILSA H TOLEDO D.M.D. (PRESIDENT/OWNER)
(561) 215-1603
Entity
Organization
Contact information
Practice address
13421 S SHORE BLVD, SUITE 203, WELLINGTON, FL 33414-7210
(561) 215-1603
(561) 537-5738
Mailing address
13421 S SHORE BLVD, SUITE 203, WELLINGTON, FL 33414-7210
(561) 215-1603
(561) 537-5738
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/24/2016
Last updated
06/24/2016
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