Provider Demographics
NPI:1316626989
Name:IGLESIAS BARRETO, ISKRA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ISKRA
Middle Name:MARIA
Last Name:IGLESIAS BARRETO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9955 NW 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1450
Mailing Address - Country:US
Mailing Address - Phone:305-930-2482
Mailing Address - Fax:
Practice Address - Street 1:6702 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4013
Practice Address - Country:US
Practice Address - Phone:305-930-2482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN283151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice