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Individual

MOUNIKA FALEMBAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
13127 KINGS LAKE DR UNIT 101, GIBSONTON, FL 33534-3958
(813) 677-3047
(813) 284-7959
Mailing address
6815 SCENIC DR, APOLLO BEACH, FL 33572-1543
(813) 408-4634

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
18289
FL
1223P0221X
Pediatric Dentistry
Primary
18289
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007161100
FL
01
1144472713
DENTAQUEST
FL
05
2188062
TX
01
9309
MCNA
FL
Enumeration date
10/15/2008
Last updated
06/30/2020
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