MEDICARE: DESIGN A SMILE PA

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	DN14151	FL

General Provider Information

NPI Number	:	1760867774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESIGN A SMILE PA

Provider Business Mailing Address
First Line	:	6437 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4827
Country	:	US
Telephone Number	:	305-667-8887
Fax Number	:	305-667-2166

Provider Business Practice Location Address
First Line	:	6437 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4827
Country	:	US
Telephone Number	:	305-667-8887
Fax Number	:	305-667-2166

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICARDO ROMAY
Credential	:	DMD
Telephone Number	:	305-667-8887

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	01/05/2016

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Directions to “DESIGN A SMILE PA ” Practice Location

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