Organization
MAIN STREET ORTHODONTICS OF MIAMI LAKES, P.A.
Active
Other names
Main Street Children's Dentistry of Miami Lakes
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELVYN GOBER DDS (CEO)
(305) 274-2499
Entity
Organization
Contact information
Practice address
15600 NW 67TH AVE, SUITE 110, MIAMI LAKES, FL 33014-2174
(305) 823-8831
(305) 823-8799
Mailing address
13195 SW 134TH ST, 2ND FLOOR, MIAMI, FL 33186-4461
(305) 274-2499
(305) 274-9312
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/04/2010
Last updated
07/10/2012
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