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General NPI Number Information
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NPI Number | 1508480187
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Entity Type | Individual
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Provider Name | JENNY CORTES DMD
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Gender | Female
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Dates
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Enumeration Date | 05/30/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 1005 E COMMERCIAL BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3956
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Country | US
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Telephone | 786-257-7189
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 E COMMERCIAL BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3956
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Country | US
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Telephone | 954-261-5665
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN24860
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License Number State | FL
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