Provider Demographics
NPI:1093245920
Name:SOTO, IVETTE F (DDS)
Entity Type:Individual
Prefix:
First Name:IVETTE
Middle Name:F
Last Name:SOTO
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 1:1903 COLORADO BLVD APT C
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7502
Mailing Address - Country:US
Mailing Address - Phone:832-660-3982
Mailing Address - Fax:
Practice Address - Street 1:5050 TEASLEY LN STE 110
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-3802
Practice Address - Country:US
Practice Address - Phone:832-660-3982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice