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General NPI Number Information
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NPI Number | 1861110066
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Entity Type | Organization
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Legal Business Name | SPECIALTY SMILES PLLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 12781 MIRAMAR PKWY STE 204
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City | MIRAMAR
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State | FL
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Zip | 33027-2908
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Country | US
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Telephone | 954-450-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 16375 NW 67TH AVE
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City | MIAMI LAKES
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State | FL
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Zip | 33014-6044
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Country | US
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Telephone | 305-822-6784
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Fax |
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Authorized Official
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Title or Position | ORTHODONTICS/ OWNER
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Name | EDDY J SEDENO III
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Credential | DMD MS
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Telephone | 305-822-6784
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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 |
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License Number State |
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