Provider Demographics
NPI:1043388721
Name:TEJEDOR, VERONICA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:TEJEDOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10023 BAY HARBOR TER
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-1509
Mailing Address - Country:US
Mailing Address - Phone:954-438-4282
Mailing Address - Fax:978-477-2671
Practice Address - Street 1:861 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3703
Practice Address - Country:US
Practice Address - Phone:305-860-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 145141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice