Provider Demographics
NPI:1508017633
Name:TENDLER, MINELLE MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MINELLE
Middle Name:MARIE
Last Name:TENDLER
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 1:199 W PALMETTO PARK RD STE D
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3849
Mailing Address - Country:US
Mailing Address - Phone:561-826-7955
Mailing Address - Fax:561-826-7957
Practice Address - Street 1:199 W PALMETTO PARK RD STE D
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3849
Practice Address - Country:US
Practice Address - Phone:561-826-7955
Practice Address - Fax:561-826-7957
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN176651223X0400X
PR27231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics