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General NPI Number Information
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NPI Number | 1316149164
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Entity Type | Organization
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Legal Business Name | ANGELICA CARDENAS MANSUR, D.M.D., P.A.
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/24/2009
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Provider Practice Location Address
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Address Line | 3030 NE 41ST TER
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City | HOMESTEAD
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State | FL
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Zip | 33033-6619
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Country | US
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Telephone | 305-245-3366
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Fax | 305-246-5200
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Provider Business Mailing Address
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Address Line | 3030 NE 41ST TER
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City | HOMESTEAD
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State | FL
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Zip | 33033-6619
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Country | US
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Telephone | 305-245-3366
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Fax | 305-246-5200
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Authorized Official
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Title or Position | DENTISIT
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Name | ANGELICA CARDENAS-MANSUR
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Credential | D.M.D.,P.A.
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Telephone | 305-245-3366
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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 | DN0016290
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License Number State | FL
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