Provider Demographics
NPI:1790114775
Name:GARRIGO, LUIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:
Last Name:GARRIGO
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 1:7550 S RED RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5343
Mailing Address - Country:US
Mailing Address - Phone:305-667-7826
Mailing Address - Fax:305-666-4462
Practice Address - Street 1:7550 S RED RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5343
Practice Address - Country:US
Practice Address - Phone:305-667-7826
Practice Address - Fax:305-666-4462
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist