Organization
ELITE SMILES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FABIOLA ORTEGA DDS (OWNER)
(305) 586-2328
Entity
Organization
Contact information
Practice address
18240 SW 147TH AVE, MIAMI, FL 33187-1813
(305) 570-1833
Mailing address
15645 SW 176TH TER, MIAMI, FL 33187-6706
(305) 570-1833
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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