Organization
DENTAL ESTHETIC SMILE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL DUCONGER (MANAGER)
(786) 372-3842
Entity
Organization
Contact information
Practice address
10121 SW 40TH ST, MIAMI, FL 33165-3947
(305) 615-9355
Mailing address
10121 SW 40TH ST, MIAMI, FL 33165-3947
(305) 615-9355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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