MEDICARE: LEMUS DENTAL GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN20326	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083088983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEMUS DENTAL GROUP LLC

Provider Business Mailing Address
First Line	:	5171 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2474
Country	:	US
Telephone Number	:	305-567-0236
Fax Number	:	305-442-9333

Provider Business Practice Location Address
First Line	:	5171 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2474
Country	:	US
Telephone Number	:	305-567-0236
Fax Number	:	305-442-9333

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. ISEL G LEMUS
Credential	:	DMD
Telephone Number	:	305-567-0236

Provider Enumeration Date	:	11/16/2015
Last Update Date	:	11/16/2015

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Directions to “LEMUS DENTAL GROUP LLC ” Practice Location

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