Provider Demographics
NPI:1104049220
Name:MANTEIGA, FRANK F (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:F
Last Name:MANTEIGA
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 1:11801 SW 69TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4768
Mailing Address - Country:US
Mailing Address - Phone:305-667-9938
Mailing Address - Fax:
Practice Address - Street 1:7800 SW 57TH AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5528
Practice Address - Country:US
Practice Address - Phone:305-667-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0012631122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist