Individual
MR. BUENAVENTURA CAGUIOA DATU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTAL HYGIENIST
Contact information
Practice address
2960 LAKELAND HIGHLANDS RD, LAKELAND, FL 33803-4370
(863) 665-1545
Mailing address
2960 LAKELAND HIGHLAND, LAKELAND, FL 33803
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
20635
FL
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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