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General NPI Number Information
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NPI Number | 1851260038
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Entity Type | Organization
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Legal Business Name | BOWTIE DENTAL
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 12035 S DIXIE HWY
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City | PINECREST
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State | FL
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Zip | 33156-5234
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Country | US
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Telephone | 305-233-8000
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Fax | 305-230-3505
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Provider Business Mailing Address
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Address Line | PO BOX 565005
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City | MIAMI
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State | FL
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Zip | 33256-5005
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Country | US
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Telephone | 305-233-8000
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Fax | 305-230-3505
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Authorized Official
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Title or Position | OWNER
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Name | RONALD JARQUIN
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Credential | DMD
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Telephone | 305-224-3319
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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 |
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License Number State |
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