Organization
ILLUSTRADENT KEY BISCAYNE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARA PILAVSKY DDS (MANAGING MEMBER)
(305) 361-5493
Entity
Organization
Contact information
Practice address
240 CRANDON BLVD, SUITE 104, KEY BISCAYNE, FL 33149-1543
(305) 361-5493
Mailing address
236 WOODLANDS RD, HARRISON, NY 10528-1322
(305) 361-5493
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18909
FL
Other
Enumeration date
05/11/2015
Last updated
12/22/2015
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