| Main Street Children's Dentistry Of Miami Lakes | |
|
15600 Nw 67 Ave Suite 110 Miami Lakes FL 33014 | |
| (305) 823-8831 | |
| Not Available |
| Full Name | Main Street Children's Dentistry Of Miami Lakes |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 15600 Nw 67 Ave, Miami Lakes, Florida |
| Authorized Official Name and Position | Stephanie Gomez (PROVIDER RELATIONS) |
| 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 134 St 2nd Floor Miami FL 33186 Ph: (305) 274-2499 | Main Street Children's Dentistry Of Miami Lakes 15600 Nw 67 Ave Suite 110 Miami Lakes FL 33014 Ph: (305) 823-8831 |
| NPI Number | 1811009194 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811009194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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