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Individual

LAUREN LOURDES MANTILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5607 NW 27TH AVE STE 2, MIAMI, FL 33142-2826
(305) 637-6400
(305) 636-5155
Mailing address
5607 NW 27TH AVE STE 1, MIAMI, FL 33142-2826
(305) 805-1700
(305) 805-1715

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN29089
FL

Other

Enumeration date
04/24/2024
Last updated
09/03/2025
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