Provider Demographics
NPI:1558563932
Name:RONQUILLO ARTILES, DORA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DORA
Middle Name:
Last Name:RONQUILLO ARTILES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DORA
Other - Middle Name:RONQUILLO
Other - Last Name:ARTILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:12600 SW 120TH ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-9066
Mailing Address - Country:US
Mailing Address - Phone:305-971-7773
Mailing Address - Fax:305-971-7882
Practice Address - Street 1:12600 SW 120TH ST
Practice Address - Street 2:SUITE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-9066
Practice Address - Country:US
Practice Address - Phone:305-971-7773
Practice Address - Fax:305-971-7882
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice