Organization
IVANOV MIAMI LAKES PLLC
Active
Organization
IVANOV MIAMI LAKES PLLC
Active
Other names
Ivanov Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
PAVEL IVANOV DMD (PRESIDENT)
(954) 240-4016
Entity
Organization
Contact information
Practice address
16375 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
(786) 946-0005
(786) 946-0019
Mailing address
16375 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
(786) 946-0005
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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