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General NPI Number Information
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NPI Number | 1730650839
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Entity Type | Organization
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Legal Business Name | SMILE FAMILY DENTAL GROUP LLC
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/19/2018
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Provider Practice Location Address
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Address Line | 1900 CORAL WAY STE 200
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City | CORAL GABLES
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State | FL
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Zip | 33145-2661
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Country | US
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Telephone | 305-509-7949
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Fax | 305-459-7578
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Provider Business Mailing Address
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Address Line | 1900 CORAL WAY STE 200
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City | CORAL GABLES
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State | FL
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Zip | 33145-2661
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Country | US
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Telephone | 305-509-7949
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Fax | 305-459-7578
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. PATRICIA CABAL
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Credential |
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Telephone | 305-509-7949
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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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