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General NPI Number Information
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NPI Number | 1306189386
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Entity Type | Organization
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Legal Business Name | NORTH MIAMI DENTAL, INC
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 610 NE 124TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5523
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Country | US
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Telephone | 305-893-5433
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Fax | 305-893-4475
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Provider Business Mailing Address
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Address Line | 610 NE 124TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-5523
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Country | US
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Telephone | 305-893-5433
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Fax | 305-893-4475
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. DENISE ROBINSON
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Credential |
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Telephone | 305-893-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN0014786
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License Number State | FL
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