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General NPI Number Information
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NPI Number | 1508624388
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Entity Type | Organization
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Legal Business Name | DENTAL PEARL RESTORATIVE & COSMETIC DENTISTRY PA
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 14771 BISCAYNE BLVD
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City | NORTH MIAMI
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State | FL
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Zip | 33181-1217
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Country | US
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Telephone | 305-816-6620
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Fax | 877-651-3774
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Provider Business Mailing Address
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Address Line | 14771 BISCAYNE BLVD
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City | NORTH MIAMI
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State | FL
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Zip | 33181-1217
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Country | US
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Telephone | 305-816-6620
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Fax | 877-651-3774
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Authorized Official
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Title or Position | OWNER
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Name | MR. LEONID KLAUSE
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Credential | OWNER
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Telephone | 305-816-6620
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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 |
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License Number State |
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