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General NPI Number Information
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NPI Number | 1518571801
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Entity Type | Organization
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Legal Business Name | THE VELIS BROTHERS DENTAL TEAM
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 10449 NW 41 ST.
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City | DORAL
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State | FL
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Zip | 33178
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Country | US
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Telephone | 305-629-9909
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Fax | 305-629-9210
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Provider Business Mailing Address
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Address Line | 10449 NW 41 ST
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City | DORAL
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State | FL
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Zip | 33178
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Country | US
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Telephone | 305-629-9909
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Fax | 305-629-9210
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. JORGE A VELIS
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Credential | DDS
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Telephone | 305-629-9909
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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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