| Elitedent Corporation | |
|
12538 Sw 120th St Miami FL 33186-9064 | |
| (305) 646-6700 | |
| Not Available |
| Full Name | Elitedent Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12538 Sw 120th St, Miami, Florida |
| Authorized Official Name and Position | Jacqueline Correa (D.M.D) |
| Authorized Official Contact | 3056466700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elitedent Corporation 12538 Sw 120th St Miami FL 33186-9064 Ph: (305) 646-6700 | Elitedent Corporation 12538 Sw 120th St Miami FL 33186-9064 Ph: (305) 646-6700 |
| NPI Number | 1861888976 |
|---|---|
| Provider Enumeration Date | 04/15/2015 |
| Last Update Date | 04/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861888976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN17602 (Florida) | Primary |
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