| Mgm Dental Pa | |
|
15659 Sw 88th St Miami FL 33196 | |
| (786) 558-7315 | |
| (786) 558-7318 |
| Full Name | Mgm Dental Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15659 Sw 88th St, Miami, Florida |
| Authorized Official Name and Position | Maria Gabriela Mogollon (OWNER) |
| Authorized Official Contact | 7865971636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mgm Dental Pa 15659 Sw 88th St Miami FL 33196-1103 Ph: (786) 558-7315 | Mgm Dental Pa 15659 Sw 88th St Miami FL 33196 Ph: (786) 558-7315 |
| NPI Number | 1396043576 |
|---|---|
| Provider Enumeration Date | 03/11/2011 |
| Last Update Date | 07/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396043576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | DN20484 (Florida) | Primary |
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