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10271 Sw 72nd St # D106 Miami FL 33173-3024 | |
| (305) 595-5655 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 10271 Sw 72nd St # D106, Miami, Florida |
| Authorized Official Name and Position | Judith Lubin (PERIODONTIST/VICEPRESIDENT) |
| Authorized Official Contact | 3055955655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10271 Sw 72nd St # D106 Miami FL 33173-3024 Ph: (305) 595-5655 | 10271 Sw 72nd St # D106 Miami FL 33173-3024 Ph: (305) 595-5655 |
| NPI Number | 1851748149 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 05/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851748149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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