| Cosmetic & Implant Designs Group Pa | |
|
4825 Coconut Creek Pkwy Coconut Creek FL 33063-3944 | |
| (954) 642-2203 | |
| Not Available |
| Full Name | Cosmetic & Implant Designs Group Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4825 Coconut Creek Pkwy, Coconut Creek, Florida |
| Authorized Official Name and Position | Johnny Peralta Lee (OWNER) |
| Authorized Official Contact | 9543949364 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cosmetic & Implant Designs Group Pa 4825 Coconut Creek Pkwy Coconut Creek FL 33063-3944 Ph: (954) 642-2203 | Cosmetic & Implant Designs Group Pa 4825 Coconut Creek Pkwy Coconut Creek FL 33063-3944 Ph: (954) 642-2203 |
| NPI Number | 1457095630 |
|---|---|
| Provider Enumeration Date | 04/25/2022 |
| Last Update Date | 04/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457095630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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