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General NPI Number Information
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NPI Number | 1487942918
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Entity Type | Individual
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Provider Name | ZULMA CONSTANZA CANOLA DMD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 5317 W ATLANTIC AVE SUITE 101
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8175
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Country | US
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Telephone | 561-279-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 1171 NW 106TH AVE
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City | PLANTATION
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State | FL
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Zip | 33322-7817
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Country | US
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Telephone | 954-554-6308
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 18678
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License Number State | FL
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