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DR. MARIO HERNANDEZ D.D.S
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1487820296
Individual Registrant:DR. MARIO HERNANDEZ D.D.S
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1870 FOREST HILL BLVD SUITE 103 LAKE CLARKE SHORES, FL 33406-8901 US
Tel: 561-585-5891 Fax: 561-586-6014
Tel: 561-585-5891 Fax: 561-586-6014
Contact information for business:
1870 FOREST HILL BLVD SUITE 103 LAKE CLARKE SHORES, FL 33406-8901 US
Tel: 561-585-5891 Fax: 561-586-6014
Tel: 561-585-5891 Fax: 561-586-6014
Registration Information:
NPI: 1487820296
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | FL | DN0013087 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
