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General NPI Number Information
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NPI Number | 1285764548
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Entity Type | Individual
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Provider Name | KELI TENFUSS MACIEL DDS
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 435 E SHERIDAN ST
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City | DANIA
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State | FL
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Zip | 33004-5502
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Country | US
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Telephone | 954-926-5888
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Fax | 954-926-7913
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Provider Business Mailing Address
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Address Line | 17125 N BAY RD #3107
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-3447
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Country | US
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Telephone | 954-926-5888
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Fax | 954-926-7913
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN15912
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License Number State | FL
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