| NPI | 1457107203 |
|---|---|
| Former Name | JOSE R MENDEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 003495) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 003495) |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |