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General NPI Number Information
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NPI Number | 1063717734
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Entity Type | Individual
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Provider Name | KATTY IGLESIAS DMD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 2600 NW 87TH AVE SUITE 29
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City | DORAL
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State | FL
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Zip | 33172-1621
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Country | US
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Telephone | 305-225-5050
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Fax | 305-593-8825
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Provider Business Mailing Address
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Address Line | 2600 NW 87TH AVE SUITE 29
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City | DORAL
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State | FL
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Zip | 33172-1621
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Country | US
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Telephone | 305-225-5050
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Fax | 305-593-8825
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN19261
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License Number State | FL
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