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Individual

MICHAEL KALE ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
10590 ENDURING FREEDOM DR, FORT DRUM, NY 13602-5503
(915) 479-0493
Mailing address
10590 ENDURING FREEDOM DR, FORT DRUM, NY 13602-5503
(915) 479-0493

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
37607
TX

Other

Enumeration date
08/02/2021
Last updated
09/06/2022
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Product
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