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General NPI Number Information
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NPI Number | 1306864509
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Entity Type | Individual
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Provider Name | JORGE R CONCEPCION D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 11944 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33184-1672
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Country | US
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Telephone | 305-221-5112
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Fax | 305-221-5640
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Provider Business Mailing Address
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Address Line | 13310 SW 20TH ST
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City | MIAMI
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State | FL
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Zip | 33175-1100
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Country | US
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Telephone | 305-510-5479
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 15638
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License Number State | FL
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