Individual
DR. GLENDA IVIS DE LA PAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
21202 OLEAN BLVD STE E2, PORT CHARLOTTE, FL 33952-6723
(941) 629-3200
Mailing address
21202 OLEAN BLVD STE E2, PORT CHARLOTTE, FL 33952-6723
(941) 629-3200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN26925
FL
Other
Enumeration date
06/02/2022
Last updated
06/03/2022
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