Healthcare Provider Details

I. General information

NPI: 1245310515
Provider Name (Legal Business Name): MANUEL OSWALDO SAENZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11865 SW 26TH ST C39
MIAMI FL
33175-2400
US

IV. Provider business mailing address

8200 SW 135TH AVE
MIAMI FL
33183-4183
US

V. Phone/Fax

Practice location:
  • Phone: 305-227-0600
  • Fax: 305-227-6928
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN14784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: