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General NPI Number Information
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NPI Number | 1780920421
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Entity Type | Organization
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Legal Business Name | MENDEZ DENTAL INC
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 12/28/2012
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Provider Practice Location Address
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Address Line | 9100 CORAL WAY SUITE 9
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City | MIAMI
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State | FL
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Zip | 33165-2076
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Country | US
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Telephone | 305-227-7997
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Fax | 305-675-3237
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Provider Business Mailing Address
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Address Line | 9100 CORAL WAY SUITE 9
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City | MIAMI
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State | FL
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Zip | 33165-2076
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Country | US
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Telephone | 305-227-7997
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Fax | 305-675-3237
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTONIO MENDEZ
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Credential | D.M.D.
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Telephone | 305-227-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN13520
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License Number State | FL
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