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General NPI Number Information
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NPI Number | 1982213518
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Entity Type | Organization
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Legal Business Name | PEOPLE FIRST DENTISTRY, PLLC
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 7890 SW 104TH ST UNIT B102A
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City | MIAMI
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State | FL
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Zip | 33156-2762
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Country | US
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Telephone | 786-310-3540
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Fax |
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Provider Business Mailing Address
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Address Line | 7165 SW 22ND ST
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City | MIAMI
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State | FL
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Zip | 33155-1626
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Country | US
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Telephone | 786-376-9610
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Fax |
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Authorized Official
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Title or Position | MEMBER/ OWNER
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Name | DR. OMAR XAVIER VILLAVICENCIO
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Credential | DDS
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Telephone | 786-310-3540
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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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