Provider Demographics
NPI:1124581194
Name:FRIAS FIGUEREDO, LISET MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:LISET
Middle Name:MARIA
Last Name:FRIAS FIGUEREDO
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 1:12468 SW 121ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5169
Mailing Address - Country:US
Mailing Address - Phone:281-865-5379
Mailing Address - Fax:
Practice Address - Street 1:12350 SW 127TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6595
Practice Address - Country:US
Practice Address - Phone:305-232-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26257122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist