Organization
MAIN STREET CHILDREN'S DENTISTRY AT PALMETTO HOSPITAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (PROVIDER RELATIONS)
(305) 274-2499
Entity
Organization
Contact information
Practice address
7150 W 20 AVE, SUITE 103, HIALEAH, FL 33016
(305) 556-9020
Mailing address
13195 SW 134 ST, 2ND FLOOR, MIAMI, FL 33186
(305) 274-2499
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/21/2014
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