Individual
LISETT MATA ALVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
18070 S TAMIAMI TRL # 101, FORT MYERS, FL 33908-4602
(239) 236-4884
Mailing address
4208 SW SANTA BARBARA PL, CAPE CORAL, FL 33914-8434
(786) 916-4453
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN28432
FL
Other
Enumeration date
06/15/2021
Last updated
07/19/2023
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