| |
9990 Nw 6th Ct Bay 16 Pembroke Pines FL 33024-6157 | |
(954) 534-9651 | |
(954) 639-7835 |
Full Name | |
---|---|
Speciality | Dentist |
Location | 9990 Nw 6th Ct, Pembroke Pines, Florida |
Authorized Official Name and Position | Tosha Renae Williams (GENERAL DENTIST/OWNER) |
Authorized Official Contact | 9545349651 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
9990 Nw 6th Ct Bay 16 Pembroke Pines FL 33024-6157 Ph: (954) 534-9651 | 9990 Nw 6th Ct Bay 16 Pembroke Pines FL 33024-6157 Ph: (954) 534-9651 |
NPI Number | 1841721610 |
---|---|
Provider Enumeration Date | 03/23/2017 |
Last Update Date | 03/23/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841721610 | NPI | - | NPPES |
08124200 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DN19661 (Florida) | Primary |
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