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Organization
SOUTH FLORIDA JAW AND FACIAL SURGERY-DENTAL IMPLANTS CENTER PA
Active
Organization
SOUTH FLORIDA JAW AND FACIAL SURGERY-DENTAL IMPLANTS CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILLIE ACOSTA FERNANDEZ (PRACTICE ADMINISTRATOR)
(305) 661-5297
Entity
Organization
Contact information
Practice address
7600 S RED RD STE 101, SOUTH MIAMI, FL 33143-5429
(305) 661-5297
(305) 667-3503
Mailing address
7600 S RED RD STE 101, SOUTH MIAMI, FL 33143-5429
(305) 661-5297
(305) 667-3503
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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