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General NPI Number Information
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NPI Number | 1487875233
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Entity Type | Individual
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Provider Name | IRIS M SANTOS DMD
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 4126 INDEPENDENT DR
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City | MARIANNA
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State | FL
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Zip | 32448-4023
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Country | US
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Telephone | 850-394-4907
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Fax |
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Provider Business Mailing Address
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Address Line | 403 E 11TH ST STE 140
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City | PANAMA CITY
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State | FL
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Zip | 32401-3409
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Country | US
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Telephone | 850-747-5599
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Fax | 850-872-4131
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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 | 1455
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License Number State | PR
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