Provider Demographics
NPI:1528819554
Name:MINT32 DENTAL PLLC
Entity type:Organization
Organization Name:MINT32 DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF DENTAL SURGERY
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIDY
Authorized Official - Middle Name:FERNANDA
Authorized Official - Last Name:RIANO GALEANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-519-0634
Mailing Address - Street 1:1351 ALAFAYA TRL STE 1017
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9100
Mailing Address - Country:US
Mailing Address - Phone:407-519-0634
Mailing Address - Fax:
Practice Address - Street 1:1351 ALAFAYA TRL STE 1017
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9100
Practice Address - Country:US
Practice Address - Phone:407-519-0634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental