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Organization
HIALEAH DENTAL SPECIALTY GROUP
Active
Organization
HIALEAH DENTAL SPECIALTY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS LAZO DDS (OWNER)
(305) 558-1211
Entity
Organization
Contact information
Practice address
900 W 49TH ST STE 400, HIALEAH, FL 33012-3407
(305) 558-1211
(305) 557-6360
Mailing address
900 W 49TH ST STE 400, HIALEAH, FL 33012-3407
(305) 557-6360
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
08/18/2026
Last updated
08/19/2026
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