| Main Street Orthodontics Of South Broward | |
|
9900 Stirling Rd., Suite 100 Cooper City FL 33024 | |
| (954) 432-8707 | |
| Not Available |
| Full Name | Main Street Orthodontics Of South Broward |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 9900 Stirling Rd., Suite 100, Cooper City, 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 Orthodontics Of South Broward 13195 Sw 134 St 2nd Floor Miami FL 33186 Ph: (305) 274-2499 | Main Street Orthodontics Of South Broward 9900 Stirling Rd., Suite 100 Cooper City FL 33024 Ph: (954) 432-8707 |
| NPI Number | 1891807160 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891807160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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