Healthcare Provider Details

I. General information

NPI: 1467775577
Provider Name (Legal Business Name): TIN WAI HUI, D.M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 SW 104TH ST DENTAL OFFICE IN K-MART
MIAMI FL
33156-3632
US

IV. Provider business mailing address

7900 SW 104TH ST DENTAL OFFICE IN K-MART
MIAMI FL
33156-3632
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-4548
  • Fax: 305-595-8623
Mailing address:
  • Phone: 305-595-4548
  • Fax: 305-595-8623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN12723
License Number StateFL

VIII. Authorized Official

Name: ARES LI
Title or Position: OFFICE MANAGER
Credential:
Phone: 305-595-4548