Provider Demographics
NPI:1508282252
Name:MONTERO, DORENE (DMD)
Entity Type:Individual
Prefix:
First Name:DORENE
Middle Name:
Last Name:MONTERO
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 1:4350 SHERIDAN ST STE 201E
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3569
Mailing Address - Country:US
Mailing Address - Phone:954-964-4229
Mailing Address - Fax:
Practice Address - Street 1:4350 SHERIDAN ST STE 201E
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3569
Practice Address - Country:US
Practice Address - Phone:954-964-4229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-05
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN204601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice