Individual
MR. GUSTAVO A. LEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
12300 SOUTHSHORE BLVD STE 208, WELLINGTON, FL 33414-6237
(561) 204-4494
(561) 204-2840
Mailing address
12300 SOUTHSHORE BLVD STE 208, WELLINGTON, FL 33414-6237
(561) 204-4494
(561) 204-2840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17254
FL
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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