Organization
CORAL DENTAL SPECIALISTS LLC
Active
Organization
CORAL DENTAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRATHIMA ADUSUMILLI DMD, MS (ORTHODONTIST)
(954) 642-1013
Entity
Organization
Contact information
Practice address
11332 WILES RD, CORAL SPRINGS, FL 33076-2114
(954) 642-1013
Mailing address
11332 WILES RD, CORAL SPRINGS, FL 33076-2114
(954) 642-1013
(754) 300-1484
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
07/08/2026
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