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Organization
SCLAR ORAL SURGERY PA
Active
Organization
SCLAR ORAL SURGERY PA
Active
Other names
South Florida OMS
Organization subpart
No
Provider details
NPI number
Authorized official
RANDENA LEONARD (ADMINISTRATOR)
(305) 661-5297
Entity
Organization
Contact information
Practice address
7600 S RED RD, SUITE 101, SOUTH MIAMI, FL 33143-5428
(305) 661-5297
(305) 667-3503
Mailing address
7600 S RED RD, SUITE 101, SOUTH MIAMI, FL 33143-5428
(305) 661-5297
(305) 667-3503
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN0010151
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN8052
FL
Other
Enumeration date
06/16/2006
Last updated
01/22/2013
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