| Jacaranda Smiles Children's Dentistry And Orthodontics | |
|
18503 Pines Blvd Suite 209 Pembroke Pines FL 33029-1404 | |
| (954) 436-0502 | |
| (954) 436-0503 |
| Full Name | Jacaranda Smiles Children's Dentistry And Orthodontics |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 18503 Pines Blvd, Pembroke Pines, Florida |
| Authorized Official Name and Position | Monika Srivastava (OWNER/DENTIST) |
| Authorized Official Contact | 2679099551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacaranda Smiles Children's Dentistry And Orthodontics 18503 Pines Blvd Suite 209 Pembroke Pines FL 33029-1404 Ph: (954) 436-0502 | Jacaranda Smiles Children's Dentistry And Orthodontics 18503 Pines Blvd Suite 209 Pembroke Pines FL 33029-1404 Ph: (954) 436-0502 |
| NPI Number | 1295269116 |
|---|---|
| Provider Enumeration Date | 04/18/2017 |
| Last Update Date | 10/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295269116 | NPI | - | NPPES |
| 003557500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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Jacaranda Smiles Children's Dentistry And Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10051 Pines Blvd, Suite C, Pembroke Pines, FL 33024 Phone: 954-251-2717 Fax: 954-613-4005 | |
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