Coral Ridge Smile
NPI #1689794505 in Ft Lauderdale, Florida
Provider Information
- NPI Number
- 1689794505
- Entity Type
- Organization
- Organization Name
- Coral Ridge Smile
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MANDANA INC.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 2, 2007
- Last Updated
- Feb 16, 2012
Practice Location
- Address
- 2324 NE 53RD ST
- City
- Ft Lauderdale
- State
- Florida
- ZIP Code
- 33308-3212
- Phone
- (954) 990-6543
Authorized Official
- Name
- DR. MANDANA MIR ESMAILI, D.D.S.
- Title
- OWNER
- Phone
- (954) 990-6543
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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