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General NPI Number Information
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NPI Number | 1386175404
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Entity Type | Organization
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Legal Business Name | HIALEAH CITY DENTAL
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 1544 W 37TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-4613
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Country | US
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Telephone | 305-558-9222
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Fax | 305-558-9333
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Provider Business Mailing Address
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Address Line | 1544 W 37TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-4613
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Country | US
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Telephone | 305-558-9222
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Fax | 305-558-9333
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Authorized Official
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Title or Position | DR
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Name | DR. ALVARO ORDONEZ
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Credential | DMD
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Telephone | 305-242-5777
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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 | DN20945
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20110
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN14911
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License Number State | FL
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