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General NPI Number Information
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NPI Number | 1689887325
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Entity Type | Organization
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Legal Business Name | COSMETIC DENTISTRY CORPORATION
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 960 ARTHUR GODFREY RD SUITE 208
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3326
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Country | US
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Telephone | 305-531-7977
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Fax | 305-531-7970
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Provider Business Mailing Address
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Address Line | 960 ARTHUR GODFREY RD SUITE 208
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3326
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Country | US
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Telephone | 305-531-7977
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Fax | 305-531-7970
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Authorized Official
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Title or Position | OWNER, DOCTOR
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Name | DR. ELENA KATZ
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Credential |
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Telephone | 305-531-7977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | DN-15193
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License Number State | FL
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