Organization
COUNTYLINE DENTAL, LLP
Active
Other names
Family Dentistry of Florida, Countyline
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IGOR PASISNITCHENKO (MEMBER)
(305) 654-1234
Entity
Organization
Contact information
Practice address
21457 NW 2ND AVE, MIAMI, FL 33169-2120
(305) 654-1234
(484) 348-0322
Mailing address
21457 NW 2ND AVE, MIAMI, FL 33169-2120
(305) 654-1234
(484) 348-0322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15470
FL
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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