Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DTP 492 | FL |
NPI | 1013248079 |
---|---|
Provider Name | Dr. Luz D. Oreste |
First Address | Gainesville, FL 32610-0405 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2010 |
Last Update Date | 14/01/2010 |