Individual
JUAN ALVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
814 N KENTUCKY AVE, LAKELAND, FL 33801-1706
(863) 687-8475
Mailing address
6527 68TH ST E, BRADENTON, FL 34203-9760
(941) 524-1878
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
21058
FL
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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