Provider Demographics
NPI:1043389232
Name:LESTER, MANUEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:LESTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 W 68TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4437
Mailing Address - Country:US
Mailing Address - Phone:305-821-7008
Mailing Address - Fax:305-557-8463
Practice Address - Street 1:1770 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4437
Practice Address - Country:US
Practice Address - Phone:305-821-7008
Practice Address - Fax:305-557-8463
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN97941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice