Organization
MAIN STREET CHILDREN'S DENTISTRY & ORTHODONTICS OF PALMETTO BAY, PA
Active
Other names
Main Street Children's Denistry of Palmetto Bay
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (CREDENTIALING SUPERVISOR)
(305) 274-2499
Entity
Organization
Contact information
Practice address
8805 SW 144TH ST, PALMETTO BAY, FL 33176-7218
(305) 253-6944
(305) 251-9989
Mailing address
13195 SW 134 ST, 2ND FLOOR, MIAMI, FL 33186
(305) 274-2499
(305) 251-9989
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/13/2009
Last updated
07/21/2022
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