| Main Street Children's Dentistry Of Miami Lakes | |
|
15600 Nw 67th Ave Suite 110 Miami Lakes FL 33014-2174 | |
| (305) 823-8831 | |
| (305) 823-8799 |
| Full Name | Main Street Children's Dentistry Of Miami Lakes |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 15600 Nw 67th Ave, Miami Lakes, Florida |
| Authorized Official Name and Position | Melvyn Gober (CEO) |
| Authorized Official Contact | 3052742499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Children's Dentistry Of Miami Lakes 13195 Sw 134th St 2nd Floor Miami FL 33186-4461 Ph: (305) 274-2499 | Main Street Children's Dentistry Of Miami Lakes 15600 Nw 67th Ave Suite 110 Miami Lakes FL 33014-2174 Ph: (305) 823-8831 |
| NPI Number | 1154653913 |
|---|---|
| Provider Enumeration Date | 02/04/2010 |
| Last Update Date | 07/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154653913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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