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General NPI Number Information
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NPI Number | 1417860966
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Entity Type | Organization
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Legal Business Name | NOBOA DENTAL LLC/ DBA NORTHSIDE DENTAL
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 7900 NW 27TH AVE STE E238
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City | MIAMI
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State | FL
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Zip | 33147-4936
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Country | US
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Telephone | 786-588-4740
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Fax | 305-876-3194
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Provider Business Mailing Address
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Address Line | 7900 NW 27TH AVE STE E238
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City | MIAMI
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State | FL
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Zip | 33147-4936
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Country | US
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Telephone | 786-588-4740
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Fax | 305-876-3194
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA TERESA NOBOA
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Credential | DDS
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Telephone | 786-558-4740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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