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8718 Sw 72nd St Miami FL 33173-3512 | |
| (305) 273-9330 | |
| (305) 273-9331 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8718 Sw 72nd St, Miami, Florida |
| Authorized Official Name and Position | Manuel Gonzalez (GENERAL MANAGER) |
| Authorized Official Contact | 3055124589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3408 W 84th St Ste 317 Hialeah FL 33018-4944 Ph: (305) 512-4589 | 8718 Sw 72nd St Miami FL 33173-3512 Ph: (305) 273-9330 |
| NPI Number | 1093263618 |
|---|---|
| Provider Enumeration Date | 09/12/2016 |
| Last Update Date | 09/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093263618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN12593 (Florida) | Primary |
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