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General NPI Number Information
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NPI Number | 1922732379
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Entity Type | Organization
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Legal Business Name | PURE DENTAL SMILES, LLC
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 1829 NE MIAMI GDN DR
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-5035
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Country | US
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Telephone | 305-932-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 8736 NW 149TH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33018-1312
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Country | US
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Telephone | 786-660-3873
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANABEL CASADO
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Credential | DMD
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Telephone | 786-660-3873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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