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General NPI Number Information
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NPI Number | 1891156238
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Entity Type | Individual
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Provider Name | DAISY LIZ MONTOYO ROSARIO D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/13/2016
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 3319 S STATE ROAD 7 STE 213
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City | WELLINGTON
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State | FL
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Zip | 33449-8146
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Country | US
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Telephone | 561-333-8441
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Fax |
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Provider Business Mailing Address
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Address Line | 126 1ST CT
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-5101
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Country | US
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Telephone | 939-640-7475
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 060001
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN23699
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License Number State | FL
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