Individual
ENRICO S BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1776 N PINE ISLAND RD, #300, PLANTATION, FL 33322
(954) 916-0947
(954) 916-9994
Mailing address
19509 S COQUINA WAY, WESTON, FL 33332
(954) 389-0078
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15933
FL
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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