Organization
SERVIDENT MIAMI PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYLAN M RODRIGUEZ ORRACA DDS (PRESIDENT)
(786) 486-7172
Entity
Organization
Contact information
Practice address
3850 SW 87TH AVE STE 204, MIAMI, FL 33165-5473
(786) 784-4056
Mailing address
9417 SW 76TH ST APT X11, MIAMI, FL 33173-5444
(786) 486-7172
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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