Provider Demographics
NPI:1891156238
Name:MONTOYO ROSARIO, DAISY LIZ (DMD)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:LIZ
Last Name:MONTOYO ROSARIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5101
Mailing Address - Country:US
Mailing Address - Phone:939-640-7475
Mailing Address - Fax:
Practice Address - Street 1:3319 S STATE ROAD 7 STE 213
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8146
Practice Address - Country:US
Practice Address - Phone:561-333-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-13
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0600011223P0221X
FLDN236991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry