Provider Demographics
NPI:1427157320
Name:SANTAMARINA, LUIS M (DMD)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:M
Last Name:SANTAMARINA
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 1:330 SW 27TH AVE
Mailing Address - Street 2:SUITE 602
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2961
Mailing Address - Country:US
Mailing Address - Phone:305-443-9998
Mailing Address - Fax:305-644-0393
Practice Address - Street 1:330 SW 27TH AVE
Practice Address - Street 2:SUITE 602
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2961
Practice Address - Country:US
Practice Address - Phone:305-443-9998
Practice Address - Fax:305-644-0393
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist