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General NPI Number Information
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NPI Number | 1215635644
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Entity Type | Organization
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Legal Business Name | MIAMI DENTAL PARTNERS LLC
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 5645 NW 87TH AVE. SUITE 112
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City | DORAL
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State | FL
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Zip | 33178
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Country | US
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Telephone | 614-915-5078
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Fax |
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Provider Business Mailing Address
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Address Line | 15100 NW 67TH AVE STE 200
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2103
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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 | MANAGER
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Name | DR. GABRIEL ANTONIO QUINONES-BETANCOURT
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Credential | DDS
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Telephone | 614-915-5078
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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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