Pines Pediatric Dentistry And Orthodontics, PLLC
Dentist, Pediatric Dentistry in Pembroke Pines, FL. Organization (NPI-2).
NPI number1710696612
StatusActive
Last updated in NPPESNov 18, 2022
Details
- NPI
- 1710696612
- Entity type
- Organization (NPI-2)
- Legal business name
- Pines Pediatric Dentistry And Orthodontics, PLLC
- Organization subpart
- No
- Enumeration date
- Nov 18, 2022
- Certification date
- Nov 18, 2022
- Last updated
- Nov 18, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – |
Practice location
17767 Sw 2nd StPembroke Pines, FL 33029-3924
Phone 561-336-6560 · Fax 561-336-6560
Mailing address
17767 Sw 2nd StPembroke Pines, FL 33029-3924
Phone 561-336-6560 · Fax 561-336-6560
Authorized official
Mitchell Miller
Owner
5613366560
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