| Pembroke Pines Pediatric Dentistry | |
|
12311 Taft St Ste 3 Pembroke Pines FL 33026-4384 | |
| (954) 431-7199 | |
| (954) 431-9102 |
| Full Name | Pembroke Pines Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 12311 Taft St Ste 3, Pembroke Pines, Florida |
| Authorized Official Name and Position | Juan Luis Garrastazu (PRESIDENT) |
| Authorized Official Contact | 9544317199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pembroke Pines Pediatric Dentistry 12311 Taft St Ste 3 Pembroke Pines FL 33026-4384 Ph: (954) 431-7199 | Pembroke Pines Pediatric Dentistry 12311 Taft St Ste 3 Pembroke Pines FL 33026-4384 Ph: (954) 431-7199 |
| NPI Number | 1942424700 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 10/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942424700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (Florida) | Primary |
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