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Organization
PREMIER DENTAL GROUP OF HALLANDALE
Active
Organization
PREMIER DENTAL GROUP OF HALLANDALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MAZA (CEO)
(954) 458-4584
Entity
Organization
Contact information
Practice address
1701 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009-4621
(954) 458-4584
(954) 458-4078
Mailing address
1701 EAST HALLANDLE BEACH BLVD, HALLANDALE, FL 33009-4621
(954) 458-4584
(954) 458-4078
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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