Provider Demographics
NPI:1437645207
Name:ARRABAL MOREJON, GLENDA LORENA (DMD)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:LORENA
Last Name:ARRABAL MOREJON
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 1:12526 NW 11TH TRL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2468
Mailing Address - Country:US
Mailing Address - Phone:786-499-5348
Mailing Address - Fax:
Practice Address - Street 1:19086 NE 29TH AVE
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2805
Practice Address - Country:US
Practice Address - Phone:786-499-5348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23642122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist