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General NPI Number Information
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NPI Number | 1578371779
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Entity Type | Organization
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Legal Business Name | NINOSKA PEREZ ENEZ
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 1455 NW 107TH AVE STE 584
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City | DORAL
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State | FL
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Zip | 33172-2768
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Country | US
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Telephone | 786-542-5718
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Fax |
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Provider Business Mailing Address
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Address Line | 6415 NW 102ND PATH APT 213
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City | DORAL
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State | FL
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Zip | 33178-3099
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Country | US
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Telephone | 954-857-1739
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NINOSKA PEREZ ENEZ
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Credential | DDS
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Telephone | 954-857-1739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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