Fortune Smiles Inc | |
2879 S University Dr Davie FL 33328-1440 | |
(954) 474-2499 | |
(954) 474-1966 |
Full Name | Fortune Smiles Inc |
---|---|
Speciality | Dentist |
Location | 2879 S University Dr, Davie, Florida |
Authorized Official Name and Position | Madelene Michelle Trujillo (DENTIST) |
Authorized Official Contact | 3052599120 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Fortune Smiles Inc 2879 S University Dr Davie FL 33328-1440 Ph: (954) 474-2499 | Fortune Smiles Inc 2879 S University Dr Davie FL 33328-1440 Ph: (954) 474-2499 |
NPI Number | 1982077939 |
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Provider Enumeration Date | 11/12/2015 |
Last Update Date | 11/12/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982077939 | NPI | - | NPPES |
013776 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | D18770 (Florida) | Primary |
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