Provider Demographics
NPI:1831636968
Name:ARAUJO DALLA BONA, DIEGO (DDS)
Entity Type:Individual
Prefix:
First Name:DIEGO
Middle Name:
Last Name:ARAUJO DALLA BONA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 NE 11TH AVE
Mailing Address - Street 2:403
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-2180
Mailing Address - Country:US
Mailing Address - Phone:305-764-0396
Mailing Address - Fax:
Practice Address - Street 1:5521 N UNIVERSITY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4648
Practice Address - Country:US
Practice Address - Phone:954-341-1000
Practice Address - Fax:954-342-0030
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist