Organization
D. G. GRANDAL DDS, CORP
Active
Other names
Kendall Dental & Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
DELIO GARCIA (PRESIDENT)
(786) 556-2950
Entity
Organization
Contact information
Practice address
13055 SW 42ND ST STE 206, MIAMI, FL 33175-3410
(305) 846-9669
Mailing address
4605 SW 140TH CT, MIAMI, FL 33175-3631
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790006823
GENERAL PRACTICE
FL
Enumeration date
10/12/2018
Last updated
10/12/2018
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