| American Pediatric Dental Group | |
|
7950 Nw 53rd St Suite 200 Doral FL 33166-4653 | |
| (305) 407-2134 | |
| Not Available |
| Full Name | American Pediatric Dental Group |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7950 Nw 53rd St, Doral, Florida |
| Authorized Official Name and Position | William Antonio Pena (PRESIDENT) |
| Authorized Official Contact | 3054072134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| American Pediatric Dental Group 7950 Nw 53rd St Suite 200 Doral FL 33166-4653 Ph: (305) 407-2134 | American Pediatric Dental Group 7950 Nw 53rd St Suite 200 Doral FL 33166-4653 Ph: (305) 407-2134 |
| NPI Number | 1063816122 |
|---|---|
| Provider Enumeration Date | 10/20/2014 |
| Last Update Date | 10/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063816122 | NPI | - | NPPES |
| 000641100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN17608 (Florida) | Primary |
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