Provider Demographics
NPI:1154697704
Name:PIRES, CARLOS ALBERTO SOARES (DMD, MSD, MSD)
Entity type:Individual
Prefix:DR
First Name:CARLOS ALBERTO
Middle Name:SOARES
Last Name:PIRES
Suffix:
Gender:M
Credentials:DMD, MSD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3753 GRANDEWOOD BLVD
Mailing Address - Street 2:435
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7352
Mailing Address - Country:US
Mailing Address - Phone:216-642-9111
Mailing Address - Fax:216-642-8801
Practice Address - Street 1:2225 GLENWOOD DR
Practice Address - Street 2:100
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3321
Practice Address - Country:US
Practice Address - Phone:407-647-4180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0228951223P0300X
FLDN200721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics