Provider Demographics
NPI:1417324161
Name:CORTES CONTRERAS, EDUARDO (DDS,MSCD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:
Last Name:CORTES CONTRERAS
Suffix:
Gender:M
Credentials:DDS,MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11826 SW 100TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2738
Mailing Address - Country:US
Mailing Address - Phone:786-419-8922
Mailing Address - Fax:
Practice Address - Street 1:11826 SW 100TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2738
Practice Address - Country:US
Practice Address - Phone:786-419-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN215711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice