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Individual

MRS. LAURA E FUENTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14337 SW 96TH TER, MIAMI, FL 33186-1124
(786) 327-9680
Mailing address
14337 SW 96TH TER, MIAMI, FL 33186-1124
(786) 327-9680

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DRP1808
FL
1223G0001X
General Practice Dentistry
DRP1808
FL

Other

Enumeration date
04/01/2018
Last updated
04/01/2018
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