Provider Demographics
NPI:1447094107
Name:SANTANA BUBAIRE, LAZARO ESTEBAN (DDS)
Entity type:Individual
Prefix:
First Name:LAZARO
Middle Name:ESTEBAN
Last Name:SANTANA BUBAIRE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 US HIGHWAY 27 S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-4920
Mailing Address - Country:US
Mailing Address - Phone:786-380-5384
Mailing Address - Fax:
Practice Address - Street 1:1735 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-4920
Practice Address - Country:US
Practice Address - Phone:863-247-2951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist