Ivanov Miami Lakes Pllc
NPI #1245038462 in Miami Lakes, Florida
Provider Information
- NPI Number
- 1245038462
- Entity Type
- Organization
- Organization Name
- Ivanov Miami Lakes Pllc
- Primary Specialty
- Dentist - Orthodontics and Dentofacial Orthopedics
- Enumeration Date
- Mar 4, 2025
- Last Updated
- Mar 4, 2025
Practice Location
- Address
- 16375 NW 67TH AVE
- City
- Miami Lakes
- State
- Florida
- ZIP Code
- 33014-6044
- Phone
- (786) 946-0005
Authorized Official
- Name
- PAVEL IVANOV, DMD
- Title
- PRESIDENT
- Phone
- (954) 240-4016
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
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