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General NPI Number Information
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NPI Number | 1851483077
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Entity Type | Organization
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Legal Business Name | DENTAL CENTER AT BAPTIST, PA
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 8940 N. KENDALL DR. SUITE 1001-E
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City | MIAMI
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State | FL
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Zip | 33176
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Country | US
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Telephone | 305-275-8875
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Fax |
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Provider Business Mailing Address
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Address Line | 13195 SW 134 ST 2ND FLOOR
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 305-274-2499
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Fax |
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Authorized Official
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Title or Position | PROVIDER RELATIONS
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Name | STEPHANIE GOMEZ
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Credential |
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Telephone | 305-274-2499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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