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General NPI Number Information
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NPI Number | 1164116166
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Entity Type | Organization
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Legal Business Name | NORTH DENTAL CARE CORP
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 2323 NW 19TH ST STE 1
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-3400
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Country | US
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Telephone | 754-228-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 2323 NW 19TH ST STE 1
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-3400
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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 | RITA C AYALA
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Credential | DDS
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Telephone | 754-228-0909
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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 |
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