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General NPI Number Information
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NPI Number | 1467933275
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Entity Type | Organization
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Legal Business Name | ALPHA DENTAL GROUP 2 INC
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 12/26/2022
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Provider Practice Location Address
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Address Line | 5870 SW 8TH ST STE 5
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City | WEST MIAMI
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State | FL
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Zip | 33144-5052
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Country | US
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Telephone | 954-456-1939
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Fax | 954-456-1940
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Provider Business Mailing Address
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Address Line | 5870 SW 8TH ST STE 5
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City | WEST MIAMI
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State | FL
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Zip | 33144-5052
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Country | US
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Telephone | 954-456-1939
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Fax | 954-456-1940
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. PATRICIA M BOBADILLA
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Credential | D.D.S.
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Telephone | 954-456-1939
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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 | DN14173
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License Number State | FL
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