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General NPI Number Information
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NPI Number | 1639814445
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Entity Type | Organization
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Legal Business Name | S.C. DENTAL, INC
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 18900 SW 106TH AVE STE 203
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City | MIAMI
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State | FL
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Zip | 33157-7701
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Country | US
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Telephone | 786-633-0330
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Fax | 786-633-0331
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Provider Business Mailing Address
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Address Line | 18900 SW 106TH AVE STE 203
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City | MIAMI
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State | FL
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Zip | 33157-7701
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Country | US
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Telephone | 786-633-0330
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Fax | 786-633-0331
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Authorized Official
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Title or Position | OWNER, DENTIST
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Name | ANNE CHRISTINE STEPHIE CASTERA
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Credential | DMD, MS
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Telephone | 305-498-1426
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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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