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General NPI Number Information
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NPI Number | 1922552777
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Entity Type | Organization
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Legal Business Name | MIAMI DENTAL LAB ASSOCIATES,INC
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 3430 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33135-4108
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Country | US
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Telephone | 786-372-2685
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Fax |
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Provider Business Mailing Address
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Address Line | 3430 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33135-4108
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Country | US
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Telephone | 786-372-2685
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Fax |
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Authorized Official
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Title or Position | OWNER/ TECH
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Name | MRS. BELKIS GARCIA
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Credential | DL
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Telephone | 786-372-2685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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License Number | DL11692
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License Number State | FL
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