Organization
GATEWAY DENTAL KENDALL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PABLO MIRANDA DDS (OWNER/CEO)
(305) 552-1553
Entity
Organization
Contact information
Practice address
11880 SW 40TH ST, SUITE 215, MIAMI, FL 33175-3584
(305) 552-1553
(305) 577-2299
Mailing address
11880 SW 40TH ST, SUITE 215, MIAMI, FL 33175-3584
(305) 552-1553
(305) 577-2299
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
FL
1223E0200X
Endodontics
—
FL
1223G0001X
General Practice Dentistry
Primary
—
FL
1223P0300X
Periodontics
—
FL
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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