Provider Demographics
NPI:1679653158
Name:DE CARDENAS, ALBERTO ANTONIO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:ANTONIO
Last Name:DE CARDENAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8060 NW 155TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5883
Mailing Address - Country:US
Mailing Address - Phone:305-821-2752
Mailing Address - Fax:786-439-1348
Practice Address - Street 1:8060 NW 155TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5883
Practice Address - Country:US
Practice Address - Phone:305-821-2752
Practice Address - Fax:786-439-1348
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN94121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice