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1871086405
MATEO VIDALES
DAVENPORT, FL
NPI
1871086405
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: FL 23425)
Enumeration Date
2018-06-08
Last Update Date
2018-06-08
Business Address
Dr. MATEO VIDALES DMD
7700 LAKE WILSON RD
DAVENPORT, FL 33896-9601
Phone number: 863-420-3166
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Mailing Address
Dr. MATEO VIDALES DMD
1640 WISE DR
NORTH PORT, FL 34286-6830
Phone number: 941-408-6601
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