Provider Demographics
NPI:1366454944
Name:MENENDEZ, OSCAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:
Last Name:MENENDEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2682 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3120
Mailing Address - Country:US
Mailing Address - Phone:727-785-4461
Mailing Address - Fax:727-786-4036
Practice Address - Street 1:2682 W LAKE RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3120
Practice Address - Country:US
Practice Address - Phone:727-785-4461
Practice Address - Fax:727-786-4036
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9813122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist