Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN 16679 | FL |
NPI | 1063611630 |
---|---|
Provider Name | Maria C. Castaneda-Nodarse |
First Address | Boynton Beach, FL 33436-6155 |
Second Address | Boynton Beach, FL 33436-6155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 03/06/2011 |