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General NPI Number Information
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NPI Number | 1992341630
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Entity Type | Organization
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Legal Business Name | INTEGRAL DENTAL CARE, P.A.
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 8302 NW 103RD ST STE 206
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-4698
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Country | US
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Telephone | 305-556-9279
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Fax | 305-556-9279
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Provider Business Mailing Address
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Address Line | 8302 NW 103RD ST STE 206
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-4698
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Country | US
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Telephone | 305-556-9279
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Fax | 305-556-9279
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Authorized Official
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Title or Position | PRESIDENT
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Name | PEDRO M SANCHEZ
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Credential | DDS
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Telephone | 305-556-9364
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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 |
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License Number State |
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