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General NPI Number Information
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NPI Number | 1194761213
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Entity Type | Individual
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Provider Name | MARY CECILIA CROSBY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 5607 NW 27TH AVE STE 2
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City | MIAMI
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State | FL
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Zip | 33142-2826
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Country | US
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Telephone | 305-376-6400
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Fax | 305-636-5155
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Provider Business Mailing Address
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Address Line | 4300 SW 92 AVE
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City | DAVIE
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State | FL
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Zip | 33328
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Country | US
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Telephone | 954-424-1965
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN0011236
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License Number State | FL
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