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General NPI Number Information
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NPI Number | 1447576046
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Entity Type | Organization
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Legal Business Name | MIRAMAR FAMILY DENTISTRY, INC
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 9720 STIRLING ROAD 211
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City | COOPER CITY
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-437-6855
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Fax | 954-431-5740
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Provider Business Mailing Address
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Address Line | 9720 STIRLING ROAD 211
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City | COOPER CITY
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-437-6855
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Fax | 954-431-5740
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELIZABETH ZIADIE
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Credential | DDS
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Telephone | 954-437-6855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN11649
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN20249
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN12437
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License Number State | FL
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