Individual
DR. CARLIS CHANELLE SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
22911 LYDEN DR STE B, ESTERO, FL 33928-7046
(393) 123-1322
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-6100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN28461
FL
Other
Enumeration date
05/01/2023
Last updated
07/31/2023
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