MEDICARE: MTA DENTAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN17962	FL

General Provider Information

NPI Number	:	1043505068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MTA DENTAL LLC

Provider Business Mailing Address
First Line	:	6268 W SAMPLE RD
Second Line	:	UNIT 401
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-3272
Country	:	US
Telephone Number	:	305-484-7879
Fax Number	:

Provider Business Practice Location Address
First Line	:	6268 W SAMPLE RD
Second Line	:	UNIT 401
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-3272
Country	:	US
Telephone Number	:	305-484-7879
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MAYA GEORGES ASSI
Credential	:	DMD
Telephone Number	:	305-484-7879

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	06/17/2011

Similar Medicare Providers

1982428165 — NICOLA OSBORNE
Practice Location Address:

6268 W SAMPLE RD STE 441
CORAL SPRINGS, FL
33067-3272

Practice Phone: 954-842-1103
Practice Fax:

1518732072 — JORDANN RYLEE GRAVES
Practice Location Address:

4630 DOOLEY WAY
COLORADO SPRINGS, CO
80911-3272

Practice Phone: 419-689-4796
Practice Fax:

1942011002 — SANDY LEE SCHMITZ FNP
Practice Location Address:

13120 BRIDLE BIT RD
COLORADO SPRINGS, CO
80908-3272

Practice Phone: 562-412-2618
Practice Fax:

1568106169 — VALERY A HIDALGO LMHC
Practice Location Address:

7522 WILES RD , SUITE B213
CORAL SPRINGS, FL
33067

Practice Phone: 954-947-6499
Practice Fax:

1457356966 — DR. MARK N DOBIN O.D.
Practice Location Address:

8124 WILES RD
CORAL SPRINGS, FL
33067-2061

Practice Phone: 954-757-8366
Practice Fax: 954-757-2456

1376549675 — ACTIVA HEALTH SERVICES, INC.
Practice Location Address:

7451 WILES RD STE 207
CORAL SPRINGS, FL
33067-2040

Practice Phone: 954-900-1110
Practice Fax: 954-382-0377

Directions to “MTA DENTAL LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.