Provider Demographics
NPI:1679820344
Name:MENTRASTI, SYLVIA MARIA (DMD)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:MARIA
Last Name:MENTRASTI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:SYLVIA
Other - Middle Name:MARIA
Other - Last Name:SANTANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 267151
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-7151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:954-333-7563
Practice Address - Street 1:10271 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-6008
Practice Address - Country:US
Practice Address - Phone:954-447-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-12
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 198641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice