| Sawgrass Mills Mall Dental, Pa | |
|
165 Nw 136th Ave #c110 Sunrise FL 33325-2624 | |
| (954) 846-7171 | |
| (954) 846-7170 |
| Full Name | Sawgrass Mills Mall Dental, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 165 Nw 136th Ave, Sunrise, Florida |
| Authorized Official Name and Position | Rostislav Krasnov (OWNER) |
| Authorized Official Contact | 9548467171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sawgrass Mills Mall Dental, Pa 165 Nw 136th Ave #c110 Sunrise FL 33325-2624 Ph: (954) 846-7171 | Sawgrass Mills Mall Dental, Pa 165 Nw 136th Ave #c110 Sunrise FL 33325-2624 Ph: (954) 846-7171 |
| NPI Number | 1306088133 |
|---|---|
| Provider Enumeration Date | 03/25/2009 |
| Last Update Date | 07/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306088133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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