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General NPI Number Information
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NPI Number | 1346952579
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Entity Type | Organization
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Legal Business Name | CHILDRENS DENTISTRY OF AMERICA BISCAYNE LLC
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 9425 NE 6TH AVE
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2737
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Country | US
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Telephone | 954-775-0723
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Fax | 754-241-0242
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Provider Business Mailing Address
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Address Line | 9425 NE 6TH AVE
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2737
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Country | US
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Telephone | 954-775-0723
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Fax | 754-241-0242
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Authorized Official
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Title or Position | OWNER
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Name | GISLEDA A RAMOS
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Credential | DDS MS
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Telephone | 772-485-9759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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