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General NPI Number Information
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NPI Number | 1043704026
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Entity Type | Individual
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Provider Name | DR. RESHMA BADDALOO
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 12251 TAFT ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-1901
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Country | US
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Telephone | 954-394-6721
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Fax |
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Provider Business Mailing Address
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Address Line | 350 NE 211TH ST
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City | MIAMI
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State | FL
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Zip | 33179-1123
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Country | US
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Telephone | 305-302-9688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN23446
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License Number State | FL
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