Individual
JESSICA BOUZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
400 W 65TH ST, HIALEAH, FL 33012-6640
(305) 827-0434
(305) 827-0501
Mailing address
2480 W 74TH ST, HIALEAH, FL 33016-6512
(786) 704-6559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DM25090
FL
Other
Enumeration date
07/02/2020
Last updated
06/24/2024
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