| Icom Coral Springs Llc | |
|
5551 N University Dr Ste 203 Coral Springs FL 33067-4651 | |
| (954) 361-0464 | |
| (786) 221-4442 |
| Full Name | Icom Coral Springs Llc |
|---|---|
| Speciality | Dentist |
| Location | 5551 N University Dr Ste 203, Coral Springs, Florida |
| Authorized Official Name and Position | Tatiana Santiago Herzog (DENTIST) |
| Authorized Official Contact | 9543610464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icom Coral Springs Llc 611 Ne 13th St Ft Lauderdale FL 33304-1109 Ph: (954) 361-0464 | Icom Coral Springs Llc 5551 N University Dr Ste 203 Coral Springs FL 33067-4651 Ph: (954) 361-0464 |
| NPI Number | 1952171720 |
|---|---|
| Provider Enumeration Date | 01/03/2024 |
| Last Update Date | 01/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952171720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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