MEDICARE: PEDIATRIC DENTAL & ORTHODONTICS SPECIALISTS, PA

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1437949310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC DENTAL & ORTHODONTICS SPECIALISTS, PA

Provider Business Mailing Address
First Line	:	12010 HIALEAH GARDENS BLVD UNIT 1
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-4317
Country	:	US
Telephone Number	:	305-224-6766
Fax Number	:

Provider Business Practice Location Address
First Line	:	12010 HIALEAH GARDENS BLVD UNIT 1
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-4317
Country	:	US
Telephone Number	:	305-224-6766
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ANAHI A GARCIA-LABORI
Credential	:	DDS
Telephone Number	:	305-926-4116

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	05/12/2025

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