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General NPI Number Information
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NPI Number | 1952674723
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Entity Type | Organization
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Legal Business Name | NORTH MIAMI BEACH DENTAL
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Dates
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Enumeration Date | 02/09/2012
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 2040 NE 163RD ST #206
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162
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Country | US
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Telephone | 305-760-2740
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 NE 163RD ST #206
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162
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Country | US
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Telephone | 305-760-2740
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | NICHOLE HUFFMAN
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Credential |
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Telephone | 305-760-2740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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