Individual
DR. JACQUELINE FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10108 W OAKLAND PARK BLVD, SUNRISE, FL 33351-6963
(954) 900-2059
(954) 440-2995
Mailing address
10108 W OAKLAND PARK BLVD, SUNRISE, FL 33351-6963
(954) 900-2059
(954) 440-2995
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21846
FL
Other
Enumeration date
06/22/2016
Last updated
01/08/2018
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