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Organization
SOFIA FONTECILLA DDS PA
Active
Organization
SOFIA FONTECILLA DDS PA
Active
Other names
Coconut Grove Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SOFIA FONTECILLA DDS (PRESIDENT)
(786) 353-0735
Entity
Organization
Contact information
Practice address
3220 S DIXIE HWY, #101, MIAMI, FL 33133-3609
(786) 353-0735
Mailing address
3220 S DIXIE HWY, #101, MIAMI, FL 33133-3609
(786) 353-0735
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20387
FL
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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