Provider Demographics
NPI:1295816924
Name:ARZOLA, VANESSA (DMD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:ARZOLA
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 1:13419 SW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6117
Mailing Address - Country:US
Mailing Address - Phone:305-559-2663
Mailing Address - Fax:305-559-3040
Practice Address - Street 1:13419 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6117
Practice Address - Country:US
Practice Address - Phone:305-559-2663
Practice Address - Fax:305-559-3040
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN159231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice