Organization
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF PLANTATION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(727) 726-1611
Entity
Organization
Contact information
Practice address
7115 W BROWARD BLVD # 155, PLANTATION, FL 33317-2210
(954) 474-8849
Mailing address
7115 W BROWARD BLVD # 155, PLANTATION, FL 33317-2210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
FL
Other
Enumeration date
07/22/2014
Last updated
11/04/2021
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