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Organization
SUNRISE DENTAL GROUP P.A.
Active
Organization
SUNRISE DENTAL GROUP P.A.
Active
Other names
Sunrise Center for Dental Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE GOMEZ (PROVIDER RELATIONS SPECIALIST)
(305) 274-2499
Entity
Organization
Contact information
Practice address
1776 N PINE ISLAND RD STE 300, PLANTATION, FL 33322-5235
(954) 916-0947
Mailing address
13195 SW 134TH ST FL 2, MIAMI, FL 33186-4461
(305) 274-2499
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
02/10/2012
Last updated
08/04/2014
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