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Organization
LAKES MALL DENTAL CENTER , PA
Active
Organization
LAKES MALL DENTAL CENTER , PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIK O CALDERON D.M.D (PRESIDENT)
(305) 951-9988
Entity
Organization
Contact information
Practice address
11401 PINES BLVD STE 220, PEMBROKE PINES, FL 33026-4104
(954) 432-5515
Mailing address
1830 S OCEAN DR APT 2204, HALLANDALE BEACH, FL 33009-7695
(305) 951-9988
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19377
FL
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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