Provider Demographics
NPI:1891845038
Name:SANTIN, MANUEL E (DMD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:E
Last Name:SANTIN
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 1:1835 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2730
Mailing Address - Country:US
Mailing Address - Phone:305-858-4119
Mailing Address - Fax:305-858-4423
Practice Address - Street 1:1835 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2730
Practice Address - Country:US
Practice Address - Phone:305-858-4119
Practice Address - Fax:305-858-4423
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN41621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice