Family Dentistry Of Florida, Countyline | |
21457 Nw 2nd Ave Miami FL 33169-2120 | |
(305) 654-1234 | |
(484) 348-0322 |
Full Name | Family Dentistry Of Florida, Countyline |
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Speciality | Dentist - General Practice |
Location | 21457 Nw 2nd Ave, Miami, Florida |
Authorized Official Name and Position | Igor Pasisnitchenko (MEMBER) |
Authorized Official Contact | 3056541234 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Family Dentistry Of Florida, Countyline 21457 Nw 2nd Ave Miami FL 33169-2120 Ph: (305) 654-1234 | Family Dentistry Of Florida, Countyline 21457 Nw 2nd Ave Miami FL 33169-2120 Ph: (305) 654-1234 |
NPI Number | 1063620789 |
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Provider Enumeration Date | 05/18/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1063620789 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | DN15470 (Florida) | Primary |
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