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General NPI Number Information
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NPI Number | 1134700123
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Entity Type | Organization
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Legal Business Name | J.M. DENTAL GROUP INC
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 1724 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3602
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Country | US
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Telephone | 954-432-8000
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Fax | 954-432-8096
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Provider Business Mailing Address
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Address Line | 1724 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3602
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Country | US
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Telephone | 954-432-8000
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Fax | 954-432-8096
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Authorized Official
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Title or Position | OWNER
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Name | NORBERTO J HERNANDEZ
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Credential | DDS
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Telephone | 305-495-8946
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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 |
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License Number State |
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