Organization
MINT DENTAL STUDIO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAYRA BETANCOURT D.D.S. (PRESIDENT/OWNER)
(305) 826-2758
Entity
Organization
Contact information
Practice address
17701 NW 78TH AVE, HIALEAH, FL 33015-3629
(305) 826-2758
Mailing address
17701 NW 78TH AVE, HIALEAH, FL 33015-3629
13058262758
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/24/2017
Last updated
10/16/2017
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