Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN20591 | FL |
N | 1223P0700X | Prosthodontist | DNF000359 | GA |
NPI | 1033404819 |
---|---|
Provider Name | Yosveny Vento |
First Address | West Palm Beach, FL 33406 |
Second Address | West Palm Beach, FL 33406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2011 |
Last Update Date | 10/06/2015 |