| Southland Mall Dental,p.a. | |
|
20505 S Dixie Hwy Ste 1683 Cutler Bay FL 33189-1229 | |
| (305) 245-0308 | |
| (954) 846-7170 |
| Full Name | Southland Mall Dental,p.a. |
|---|---|
| Speciality | Dentist |
| Location | 20505 S Dixie Hwy, Cutler Bay, Florida |
| Authorized Official Name and Position | Rostislav Krasnov (OWNER) |
| Authorized Official Contact | 3052450308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southland Mall Dental,p.a. 20505 S Dixie Hwy Ste 1683 Cutler Bay FL 33189-1229 Ph: (305) 245-0308 | Southland Mall Dental,p.a. 20505 S Dixie Hwy Ste 1683 Cutler Bay FL 33189-1229 Ph: (305) 245-0308 |
| NPI Number | 1023381183 |
|---|---|
| Provider Enumeration Date | 02/20/2012 |
| Last Update Date | 12/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023381183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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