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Organization
CUTLER BAY DENTAL SPECIALTY PLLC
Active
Organization
CUTLER BAY DENTAL SPECIALTY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (CREDENTIALING COORDINATOR)
(305) 274-2499
Entity
Organization
Contact information
Practice address
20529 OLD CUTLER RD, CUTLER BAY, FL 33189-2454
(305) 274-2499
Mailing address
13195 SW 134TH ST, MIAMI, FL 33186-4461
(305) 274-2499
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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