| Daniela Modesto Gran Dental Inc. | |
|
2500 E Commercial Blvd Suite E Fort Lauderdale FL 33308-4124 | |
| (954) 662-7447 | |
| Not Available |
| Full Name | Daniela Modesto Gran Dental Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2500 E Commercial Blvd, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Daniela Modesto (DENTIST/PRESIDENT) |
| Authorized Official Contact | 9545543490 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniela Modesto Gran Dental Inc. 1000 Parkview Dr Apt 720 Hallandale Beach FL 33009-2932 Ph: (954) 554-3490 | Daniela Modesto Gran Dental Inc. 2500 E Commercial Blvd Suite E Fort Lauderdale FL 33308-4124 Ph: (954) 662-7447 |
| NPI Number | 1730422247 |
|---|---|
| Provider Enumeration Date | 04/03/2013 |
| Last Update Date | 04/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730422247 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN 17097 (Florida) | Secondary |
| 1223G0001X | Dentist - General Practice | DN17097 (Florida) | Primary |
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