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General NPI Number Information
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NPI Number | 1922183748
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Entity Type | Organization
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Legal Business Name | DADE FAMILY DENTAL CENTER
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1830 NW 183RD STREET
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City | OPA LOCKA
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State | FL
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Zip | 33056
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Country | US
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Telephone | 305-621-1400
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Fax | 305-620-4680
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Provider Business Mailing Address
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Address Line | 1830 NW 183RD STREET
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City | MIAMI
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State | FL
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Zip | 33056
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Country | US
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Telephone | 305-621-1400
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Fax | 305-620-4680
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. DELROY W. WEBB
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Credential | D.M.D.
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Telephone | 954-436-3628
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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 | 9016
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License Number State | FL
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