Provider Demographics
NPI:1336572007
Name:SOTO, PAOLA F (DMD)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:F
Last Name:SOTO
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 1:3911 HOLLYWOOD BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6795
Mailing Address - Country:US
Mailing Address - Phone:954-987-3344
Mailing Address - Fax:
Practice Address - Street 1:3911 HOLLYWOOD BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6795
Practice Address - Country:US
Practice Address - Phone:195-498-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 203701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice