| Dental Specialists Of Pembroke Pines Group | |
|
12558 Pines Blvd Pembroke Pines FL 33027-1713 | |
| (305) 220-8911 | |
| Not Available |
| Full Name | Dental Specialists Of Pembroke Pines Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12558 Pines Blvd, Pembroke Pines, Florida |
| Authorized Official Name and Position | Ivan Pelton (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3052208911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Specialists Of Pembroke Pines Group 12558 Pines Blvd Pembroke Pines FL 33027-1713 Ph: () - | Dental Specialists Of Pembroke Pines Group 12558 Pines Blvd Pembroke Pines FL 33027-1713 Ph: (305) 220-8911 |
| NPI Number | 1073030755 |
|---|---|
| Provider Enumeration Date | 08/24/2017 |
| Last Update Date | 08/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073030755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN5838 (Florida) | Primary |
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