Icom Hialeah LLC

NPI #1376313130 in Hialeah, Florida

Provider Information

NPI Number: 1376313130
Entity Type: Organization
Organization Name: Icom Hialeah LLC
Primary Specialty: Dentist
Enumeration Date: Jan 3, 2024
Last Updated: Jan 3, 2024

Practice Location

Address: 6600 W 12TH AVE
City: Hialeah
State: Florida
ZIP Code: 33012-6450
Phone: (305) 846-7987

Authorized Official

Name: TATIANA SANTIAGO HERZOG
Title: DENTIST
Phone: (305) 409-5392

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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