Organization
AMBIANCE SURGICAL ARTS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRI D HINES DDS (OWNER)
(786) 377-4344
Entity
Organization
Contact information
Practice address
8501 SW 124TH AVE STE 208, MIAMI, FL 33183-4633
(786) 377-4344
(786) 377-4364
Mailing address
8501 SW 124TH AVE STE 208, MIAMI, FL 33183-4633
(786) 377-4344
(786) 377-4364
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TPVP162861-09
—
FL
Enumeration date
07/26/2019
Last updated
07/26/2019
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