Individual
GUSTAVO PARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
930 S MAIN ST, LABELLE, FL 33935-4448
(863) 675-0387
(863) 675-3246
Mailing address
PO BOX 919771, ORLANDO, FL 32891-9771
(239) 278-3600
(239) 226-4650
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012768900
—
FL
Enumeration date
07/24/2014
Last updated
09/30/2020
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