Individual
JAVIER DE LA FUENTE BALBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6060 SW 62ND PL, SOUTH MIAMI, FL 33143-2170
(786) 234-4280
Mailing address
6060 SW 62ND PL, SOUTH MIAMI, FL 33143-2170
(786) 234-4280
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN24411
FL
Other
Enumeration date
04/02/2019
Last updated
07/03/2024
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