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Organization
DORAL DENTAL
Active
Organization
DORAL DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY DAVID SMITH D.M.D (DENTIST AND OWNER)
(305) 477-7601
Entity
Organization
Contact information
Practice address
10818 NW 58TH ST, DORAL, FL 33178-2854
(305) 477-7601
(305) 471-0137
Mailing address
10818 NW 58TH ST, DORAL, FL 33178-2854
(305) 477-7601
(305) 471-0137
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN 14900
FL
122300000X
Dentist
Primary
DN11702
FL
122300000X
Dentist
DN13223
FL
122300000X
Dentist
DN14811
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056546939
DENTIST
FL
01
—
595303579
DENTIST
FL
01
—
650561621
DENTIST
FL
Enumeration date
11/08/2006
Last updated
07/13/2009
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