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Organization
KEY WEST DENTAL MANAGEMENT GROUP LLC
Active
Organization
KEY WEST DENTAL MANAGEMENT GROUP LLC
Active
Other names
Key West Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ISIS SAMPEDRO (C.O.O)
(786) 226-7474
Entity
Organization
Contact information
Practice address
1215 SIMONTON ST, KEY WEST, FL 33040-3158
(305) 296-8541
Mailing address
1215 SIMONTON ST, KEY WEST, FL 33040-3158
(305) 296-8541
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024079200
—
FL
Enumeration date
09/21/2021
Last updated
09/21/2021
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