Provider Demographics
NPI:1518918606
Name:MAMMALES, DEAN WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:WILLIAM
Last Name:MAMMALES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10233 OKEECHOBEE BLVD
Mailing Address - Street 2:SUITE B6
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1401
Mailing Address - Country:US
Mailing Address - Phone:561-753-2225
Mailing Address - Fax:561-296-0378
Practice Address - Street 1:10233 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE B6
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1401
Practice Address - Country:US
Practice Address - Phone:561-753-2225
Practice Address - Fax:561-296-0378
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor