Provider Demographics
NPI:1093154098
Name:MINOSO, CLAUDIA (DDS)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:MINOSO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 N MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-3030
Mailing Address - Country:US
Mailing Address - Phone:979-541-5400
Mailing Address - Fax:
Practice Address - Street 1:1108 N MECHANIC ST
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-3030
Practice Address - Country:US
Practice Address - Phone:979-541-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist