| American Pediatric Dental Group | |
|
10021 Pines Blvd Suite 100 Pembroke Pines FL 33024-6191 | |
| (954) 417-1337 | |
| (954) 417-1338 |
| Full Name | American Pediatric Dental Group |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10021 Pines Blvd, Pembroke Pines, Florida |
| Authorized Official Name and Position | William Antonio Pena (OWNER/PRESIDENT) |
| Authorized Official Contact | 4152166649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| American Pediatric Dental Group 10021 Pines Blvd Suite 100 Pembroke Pines FL 33024-6191 Ph: (954) 417-1337 | American Pediatric Dental Group 10021 Pines Blvd Suite 100 Pembroke Pines FL 33024-6191 Ph: (954) 417-1337 |
| NPI Number | 1720374838 |
|---|---|
| Provider Enumeration Date | 06/27/2011 |
| Last Update Date | 06/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720374838 | NPI | - | NPPES |
| 000641100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN17608 (Florida) | Primary |
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