Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN10445 | FL |
NPI | 1003963182 |
---|---|
Provider Name | Mirna Bendeck |
First Address | Palm Beach Gardens, FL 33410-3224 |
Second Address | Palm Beach Gardens, FL 33410-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 09/07/2007 |