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Organization
ELITEDENT CORPORATION
Active
Organization
ELITEDENT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE CORREA (D.M.D)
(305) 646-6700
Entity
Organization
Contact information
Practice address
12538 SW 120TH ST, MIAMI, FL 33186-9064
(305) 646-6700
Mailing address
12538 SW 120TH ST, MIAMI, FL 33186-9064
(305) 646-6700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN17602
FL
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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