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General NPI Number Information
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NPI Number | 1104297530
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Entity Type | Organization
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Legal Business Name | MY SMILE CENTER
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 11/27/2018
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Provider Practice Location Address
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Address Line | 12800 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33184-1309
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Country | US
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Telephone | 786-610-9545
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Fax |
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Provider Business Mailing Address
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Address Line | 12800 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33184-1309
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RENE J FRIEDMAN
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Credential |
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Telephone | 786-414-4316
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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 |
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License Number State | FL
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