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General NPI Number Information
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NPI Number | 1821476466
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Entity Type | Organization
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Legal Business Name | ALL SMILES GENERAL DENTISTRY
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Dates
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Enumeration Date | 05/15/2015
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 12404 W DIXIE HWY
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City | NORTH MIAMI
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State | FL
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Zip | 33161
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Country | US
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Telephone | 305-893-4801
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Fax |
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Provider Business Mailing Address
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Address Line | 12404 W DIXIE HWY
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City | NORTH MIAMI
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State | FL
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Zip | 33161
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Country | US
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Telephone | 305-893-4801
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANNA S BERNKRANT
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Credential |
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Telephone | 954-483-6933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19628
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License Number State | FL
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