| Prime Pediatric Dental Group Pa | |
|
4410 W 16th Ave Ste 52 Hialeah FL 33012-7193 | |
| (305) 251-5390 | |
| Not Available |
| Full Name | Prime Pediatric Dental Group Pa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4410 W 16th Ave Ste 52, Hialeah, Florida |
| Authorized Official Name and Position | Jose Mellado (PRESIDENT) |
| Authorized Official Contact | 3053213790 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Pediatric Dental Group Pa 4410 W 16th Ave Ste 52 Hialeah FL 33012-7193 Ph: () - | Prime Pediatric Dental Group Pa 4410 W 16th Ave Ste 52 Hialeah FL 33012-7193 Ph: (305) 251-5390 |
| NPI Number | 1730906124 |
|---|---|
| Provider Enumeration Date | 09/25/2024 |
| Last Update Date | 09/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730906124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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