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General NPI Number Information
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NPI Number | 1508758871
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Entity Type | Organization
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Legal Business Name | SEAL IT WITH A SMILE PEDIATRIC DENTISTRY PLLC
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Dates
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Enumeration Date | 07/19/2025
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Last Update Date | 07/19/2025
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Provider Practice Location Address
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Address Line | 2999 NE 191ST ST STE 708
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City | AVENTURA
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State | FL
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Zip | 33180-3386
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Country | US
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Telephone | 305-786-5393
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Fax |
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Provider Business Mailing Address
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Address Line | 2999 NE 191ST ST STE 708
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City | AVENTURA
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State | FL
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Zip | 33180-3386
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Country | US
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Telephone | 305-786-5393
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. RILEY JOSEPH REARDON
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Credential | DDS
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Telephone | 813-385-6160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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