Organization
ELITE WELLNESS & DENTAL SPA LLC
Active
Other names
Elite wellness & Dental Spa LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS LOPEZ (CFO)
(786) 200-9120
Entity
Organization
Contact information
Practice address
3105 NW 107TH AVE STE 100, DORAL, FL 33172-2215
(786) 200-9120
Mailing address
3105 NW 107TH AVE STE 100, DORAL, FL 33172-2215
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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