Individual
KEIN MONTALVO VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1602 NE 163 STREET, NORTH MIAMI BEACH, FL 33162
(305) 387-3002
Mailing address
13550 SW 88TH ST, MIAMI, FL 33186-1654
(305) 387-3002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21512
PR
Other
Enumeration date
03/04/2014
Last updated
11/12/2016
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