| Main Street Children's Dentistry Of Miami Lakes, Pllc | |
|
15501 Nw 67th Ave Ste 201 Miami Lakes FL 33014-2108 | |
| (786) 577-4968 | |
| Not Available |
| Full Name | Main Street Children's Dentistry Of Miami Lakes, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 15501 Nw 67th Ave Ste 201, 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, Pllc 15501 Nw 67th Ave Ste 201 Miami Lakes FL 33014-2108 Ph: () - | Main Street Children's Dentistry Of Miami Lakes, Pllc 15501 Nw 67th Ave Ste 201 Miami Lakes FL 33014-2108 Ph: (786) 577-4968 |
| NPI Number | 1043611858 |
|---|---|
| Provider Enumeration Date | 09/11/2014 |
| Last Update Date | 06/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043611858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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