Prime Pediatric Dental Group Pa | |
4919 Sheridan St Unit 50-51 Hollywood FL 33021-2823 | |
(305) 251-5390 | |
Not Available |
Full Name | Prime Pediatric Dental Group Pa |
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Speciality | Dentist - Pediatric Dentistry |
Location | 4919 Sheridan St Unit 50-51, Hollywood, 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 |
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Prime Pediatric Dental Group Pa 13757 Sw 152nd St Miami FL 33177-8125 Ph: (305) 251-5390 | Prime Pediatric Dental Group Pa 4919 Sheridan St Unit 50-51 Hollywood FL 33021-2823 Ph: (305) 251-5390 |
NPI Number | 1316763519 |
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Provider Enumeration Date | 12/03/2024 |
Last Update Date | 12/03/2024 |
Identifier | Type | State | Issuer |
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1316763519 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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