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General NPI Number Information
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NPI Number | 1083149736
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Entity Type | Organization
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Legal Business Name | MORELL DENTAL CARE
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 3750 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4654
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Country | US
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Telephone | 305-231-0545
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Fax | 305-290-3205
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Provider Business Mailing Address
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Address Line | 3750 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4654
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Country | US
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Telephone | 305-231-0545
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Fax | 305-290-3205
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Authorized Official
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Title or Position | DOCTOR
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Name | NAYADE MORELL
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Credential |
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Telephone | 305-231-0545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN17626
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License Number State | FL
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