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General NPI Number Information
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NPI Number | 1235335688
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Entity Type | Organization
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Legal Business Name | GEORGE A. VAZQUEZ DMD PA
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2040 NE 8TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-4702
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Country | US
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Telephone | 305-245-9343
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Fax | 305-245-9393
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Provider Business Mailing Address
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Address Line | 2040 NE 8TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-4702
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Country | US
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Telephone | 305-245-9343
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Fax | 305-245-9393
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | DR. GEORGE A. VAZQUEZ
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Credential | DMD
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Telephone | 305-246-9343
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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 | DN 16870
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License Number State | FL
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