Individual
MARCO ANTONIO MONGALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2684 CAHILL WAY, LAKE MARY, FL 32746-2322
(407) 634-8544
Mailing address
2684 CAHILL WAY, LAKE MARY, FL 32746-2322
(407) 634-8544
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN11409
FL
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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