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Individual

IBIS CHAVIANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4201 PALM AVE, SUITE DD, HIALEAH, FL 33012-4424
(305) 456-6474
Mailing address
3906 SW 4TH ST, CORAL GABLES, FL 33134-1739

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 21578
FL

Other

Enumeration date
04/18/2013
Last updated
02/03/2016
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