Main Street Children's Dentistry of Miami Lakes, Pllc
NPI #1043611858 in Miami Lakes, Florida
Provider Information
- NPI Number
- 1043611858
- Entity Type
- Organization
- Organization Name
- Main Street Children's Dentistry of Miami Lakes, Pllc
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Sep 11, 2014
- Last Updated
- Jun 23, 2015
Practice Location
- Address
- 15501 NW 67TH AVE STE 201
- City
- Miami Lakes
- State
- Florida
- ZIP Code
- 33014-2108
- Phone
- (786) 577-4968
Authorized Official
- Name
- STEPHANIE GOMEZ
- Title
- PROVIDER RELATIONS
- Phone
- (305) 274-2499
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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