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15801 S Dixie Hwy Suite B Palmetto Bay FL 33157-1837 | |
| (305) 255-4140 | |
| (305) 252-8323 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15801 S Dixie Hwy, Palmetto Bay, Florida |
| Authorized Official Name and Position | Elizabeth Heredia (OFFICE MANAGER) |
| Authorized Official Contact | 3052554140 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
15801 S Dixie Hwy Suite B Palmetto Bay FL 33157-1837 Ph: (305) 255-4140 | 15801 S Dixie Hwy Suite B Palmetto Bay FL 33157-1837 Ph: (305) 255-4140 |
| NPI Number | 1689118523 |
|---|---|
| Provider Enumeration Date | 12/12/2016 |
| Last Update Date | 12/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689118523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN19253 (Florida) | Primary |
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