Provider Demographics
NPI:1508313578
Name:KESMAN, PAOLA ALEJANDRA
Entity Type:Individual
Prefix:DR
First Name:PAOLA
Middle Name:ALEJANDRA
Last Name:KESMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:PAOLA
Other - Middle Name:ALEJANDRA
Other - Last Name:KESMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:11980 NW 81 COURT
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076
Mailing Address - Country:US
Mailing Address - Phone:954-801-1442
Mailing Address - Fax:
Practice Address - Street 1:11980 NW 81 COURT
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076
Practice Address - Country:US
Practice Address - Phone:954-801-1442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist