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Organization
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF PLANTATION PA
Active
Organization
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF PLANTATION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA JOHNSON (CRO)
(941) 444-0558
Entity
Organization
Contact information
Practice address
7115 W BROWARD BLVD # 155, PLANTATION, FL 33317-2210
(954) 474-8849
Mailing address
7115 W BROWARD BLVD # 155, PLANTATION, FL 33317-2210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
FL
Other
Enumeration date
07/22/2014
Last updated
07/21/2026
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