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General NPI Number Information
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NPI Number | 1134519689
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Entity Type | Organization
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Legal Business Name | FROST DENTAL CENTER CORP
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 17501 BISCAYNE BLVD STE 570
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City | AVENTURA
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State | FL
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Zip | 33160-4810
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Country | US
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Telephone | 305-998-7992
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Fax |
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Provider Business Mailing Address
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Address Line | 17501 BISCAYNE BLVD STE 570
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City | AVENTURA
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State | FL
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Zip | 33160-4810
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Country | US
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Telephone | 305-998-7992
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JIMENA FROST
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Credential | DMD
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Telephone | 305-998-7992
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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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