Healthcare Provider Details

I. General information

NPI: 1164112165
Provider Name (Legal Business Name): ENJOY DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 W 20TH AVE STE 114
HIALEAH FL
33016-5509
US

IV. Provider business mailing address

7150 W 20TH AVE STE 114
HIALEAH FL
33016-5509
US

V. Phone/Fax

Practice location:
  • Phone: 305-871-9111
  • Fax:
Mailing address:
  • Phone: 305-871-9111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NICTE BOYLE BALBIN
Title or Position: DR.
Credential: DDS
Phone: 786-370-0069