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General NPI Number Information
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NPI Number | 1134335961
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Entity Type | Organization
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Legal Business Name | VICTOR J DONGO DMD PA
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3307 WEST 80TH STREET
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City | HIALEAH
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State | FL
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Zip | 33018
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Country | US
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Telephone | 305-512-3700
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Fax | 305-512-8555
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Provider Business Mailing Address
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Address Line | 3307 WEST 80TH STREET
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City | HIALEAH
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State | FL
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Zip | 33018
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Country | US
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Telephone | 305-512-3700
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Fax | 305-512-8555
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | VICTOR JOSE DONGO
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Credential | DMD FAGD
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Telephone | 305-512-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 14564
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License Number State | FL
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