Organization
PRIME PEDIATRIC DENTAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE MELLADO DMD (PRESIDENT)
(305) 321-3790
Entity
Organization
Contact information
Practice address
13195 BISCAYNE BAY DR, NORTH MIAMI, FL 33181-2204
(305) 251-5390
(305) 675-3282
Mailing address
13195 BISCAYNE BAY DR, NORTH MIAMI, FL 33181-2204
(305) 251-5390
(305) 675-3282
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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