Organization
PEDIATRIC DENTAL CENTER OF BISCAYNE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENRIQUE ACOSTA D.D.S,M.B.A (PRESIDENT)
(786) 368-6212
Entity
Organization
Contact information
Practice address
557 NE 81ST ST, MIAMI, FL 33138-4519
(786) 368-6212
Mailing address
2645 S DOUGLAS RD, SUITE # 703, MIAMI, FL 33133-2754
(305) 448-3228
(305) 447-8828
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN17284
FL
1223P0221X
Pediatric Dentistry
Primary
DN17284
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
03/31/2017
Last updated
04/20/2017
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