Organization
MIA DENTAL CORP
Active
Other names
South Beach Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDOR JAVIER VALLS DMD (OWNER/DENTIST)
(305) 532-6795
Entity
Organization
Contact information
Practice address
407 LINCOLN RD STE 700, MIAMI BEACH, FL 33139-3024
(305) 532-6795
(305) 728-0854
Mailing address
9451 SW 192ND DR, CUTLER BAY, FL 33157-7933
(786) 970-9723
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023742079
NPES
FL
01
—
1194255539
NPES
FL
Enumeration date
12/23/2024
Last updated
12/23/2024
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