Healthcare Provider Details

I. General information

NPI: 1255040655
Provider Name (Legal Business Name): EYR DENTAL ASSOCIATES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5870 SW 8TH ST STE 4AND5
WEST MIAMI FL
33144-5052
US

IV. Provider business mailing address

5870 SW 8TH ST STE 4AND5
WEST MIAMI FL
33144-5052
US

V. Phone/Fax

Practice location:
  • Phone: 305-407-1753
  • Fax: 305-847-2676
Mailing address:
  • Phone: 305-407-1753
  • Fax: 305-847-2676

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: ERICK YGLESIAS RUIZ
Title or Position: OWNER/DOCTOR
Credential: DDS
Phone: 305-407-1753