Organization
ICOM BAY HARBOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA SANTIAGO HERZOG DDS (DENTIST)
(305) 560-5859
Entity
Organization
Contact information
Practice address
1160 KANE CONCOURSE STE 203, BAY HARBOR ISLANDS, FL 33154-2020
(305) 560-5859
Mailing address
611 NE 13TH ST, FT LAUDERDALE, FL 33304-1109
(786) 713-9290
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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