Provider Demographics
NPI:1295464212
Name:ARENCIBIA, ANA LAURA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:LAURA
Last Name:ARENCIBIA
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 1:827 ALVIN AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-6430
Mailing Address - Country:US
Mailing Address - Phone:305-790-1484
Mailing Address - Fax:
Practice Address - Street 1:3436 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7108
Practice Address - Country:US
Practice Address - Phone:239-201-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist