Southland Mall Dental,p.a.

NPI #1023381183 in Cutler Bay, Florida

Provider Information

NPI Number: 1023381183
Entity Type: Organization
Organization Name: Southland Mall Dental,p.a.
Primary Specialty: Dentist
Enumeration Date: Feb 20, 2012
Last Updated: Dec 3, 2018

Practice Location

Address: 20505 S DIXIE HWY
Address 2: STE 1683
City: Cutler Bay
State: Florida
ZIP Code: 33189-1229
Phone: (305) 245-0308

Authorized Official

Name: ROSTISLAV KRASNOV, DDS
Title: OWNER
Phone: (305) 245-0308

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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