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Organization

LAGUNA ISLES DENTAL, LLC

Active
Other names
Laguna Isles Dental Associates, P.A.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MONEEZE MUJTABA D.D.S. (DENTIST)
(954) 680-5552
Entity
Organization

Contact information

Practice address
19551 SHERIDAN STREET, PEMBROKE PINES, FL 33332
(954) 680-5552
(954) 680-1808
Mailing address
19551 SHERIDAN STREET, PEMBROKE PINES, FL 33332
(954) 680-5552
(954) 680-1808

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
FL
1223G0001X
General Practice Dentistry
DN10651
FL
1223G0001X
General Practice Dentistry
DN17384
FL

Other

Enumeration date
12/17/2008
Last updated
09/16/2009
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