MEDICARE: PONCE DENTAL CORPORATION

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	1223G0001X	General Practice Dentistry	DN12998	FL

General Provider Information

NPI Number	:	1710236161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PONCE DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	3190 PONCE DE LEON BLVD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6826
Country	:	US
Telephone Number	:	305-774-7273
Fax Number	:

Provider Business Practice Location Address
First Line	:	3190 PONCE DE LEON BLVD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6826
Country	:	US
Telephone Number	:	305-774-7273
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MANUEL G LOPEZ
Credential	:
Telephone Number	:	305-774-7273

Provider Enumeration Date	:	08/31/2012
Last Update Date	:	08/31/2012

Similar Medicare Providers

1245162387 — PONCE DENTAL OF CORAL GABLES CORP
Practice Location Address:

3190 PONCE DE LEON BLVD
CORAL GABLES, FL
33134-6826

Practice Phone: 305-774-7273
Practice Fax: 321-400-1370

1053328211 — DR. MANUEL G LOPEZ DDS
Practice Location Address:

3190 PONCE DE LEON BLVD
CORAL GABLES, FL
33134-6826

Practice Phone: 305-774-7273
Practice Fax:

1063714111 — CORAL GABLES PHARMACY AND MEDICAL SUPPLY, INC
Practice Location Address:

3160 PONCE DE LEON BLVD
CORAL GABLES, FL
33134-6826

Practice Phone: 305-444-5115
Practice Fax: 305-444-5119

1073487922 — ALEJANDRO LEY JR. RBT
Practice Location Address:

3150 PONCE DE LEON BLVD
CORAL GABLES, FL
33134-6826

Practice Phone: 786-982-1250
Practice Fax: 305-441-1841

1871988857 — LEONARDO VARGAS
Practice Location Address:

4800 W FLAGLER ST STE 215
CORAL GABLES, FL
33134-1402

Practice Phone: 305-508-5580
Practice Fax:

1295418523 — ACTION FOR KIDS, LLC
Practice Location Address:

1300 PONCE DE LEON BLVD
CORAL GABLES, FL
33134-3346

Practice Phone: 954-601-6826
Practice Fax:

Directions to “PONCE DENTAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.