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General NPI Number Information
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NPI Number | 1750995205
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Entity Type | Individual
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Provider Name | DANIYEL IGLESIAS DDS
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Gender | Male
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 4849 SW 148TH AVE
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City | DAVIE
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State | FL
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Zip | 33330-2129
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Country | US
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Telephone | 954-880-3996
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Fax |
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Provider Business Mailing Address
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Address Line | 17320 SW 54TH ST
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City | SOUTHWEST RANCHES
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State | FL
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Zip | 33331-2310
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Country | US
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Telephone | 305-807-4557
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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 | DN25402
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License Number State | FL
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