Individual
FANNY JARQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
58 SW 10TH ST, MIAMI, FL 33130-4119
(305) 374-0996
Mailing address
5003 SW 129TH CT, MIAMI, FL 33175-5337
(305) 551-2542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17769
FL
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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