Individual
DIORGIS MANUEL SARMIENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1770 N WICKHAM RD, MELBOURNE, FL 32935-8122
(321) 253-0606
Mailing address
2540 JUDGE FRAN JAMIESON WAY, MELBOURNE, FL 32940-6208
(585) 500-7619
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24204
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24204
EGNA, SIGNA, DELTA DENTAL, BLUE CROSS BLUE SHIELD, MEDLIFE
FL
Enumeration date
06/06/2019
Last updated
06/06/2019
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