Organization
SOFIA FONTECILLA DDS PA
Active
Other names
Coconut Grove Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SOFIA FONTECILLA DDS (PRESIDENT)
(786) 353-0735
Entity
Organization
Contact information
Practice address
3220 S DIXIE HWY, #101, MIAMI, FL 33133-3609
(786) 353-0735
Mailing address
3220 S DIXIE HWY, #101, MIAMI, FL 33133-3609
(786) 353-0735
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20387
FL
Other
Enumeration date
03/08/2016
Last updated
03/08/2016
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