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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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