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General NPI Number Information
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NPI Number | 1780497933
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Entity Type | Organization
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Legal Business Name | CELIA ROMAN PA
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 3905 NW 107TH AVE
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City | DORAL
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State | FL
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Zip | 33178-2785
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Country | US
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Telephone | 305-400-9296
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Fax | 786-921-0205
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Provider Business Mailing Address
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Address Line | 3905 NW 107TH AVE
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City | DORAL
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State | FL
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Zip | 33178-2785
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Country | US
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Telephone | 305-400-9296
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Fax | 786-921-0205
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Authorized Official
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Title or Position | PRESIDENT
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Name | CELIA ROMAN
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Credential | DDS
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Telephone | 786-710-0140
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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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