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Individual

GREIVY SANTANA BASTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
9840 SW 40TH ST, MIAMI, FL 33165-3912
(305) 223-0420
Mailing address
14097 NW 16TH DR, PEMBROKE PINES, FL 33028-3010
(786) 447-8841

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24149
FL

Other

Enumeration date
06/04/2019
Last updated
06/04/2019
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