Individual
DR. JELENA MARY VATHIELIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
6309 NW 74TH TER, PARKLAND, FL 33067-1232
(954) 303-7578
Mailing address
6309 NW 74TH TER, PARKLAND, FL 33067-1232
(954) 303-7578
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 20854
FL
Other
Enumeration date
08/10/2014
Last updated
08/10/2014
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