Organization
INTERNATIONAL DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENATE E MANNS (VP)
(786) 558-4100
Entity
Organization
Contact information
Practice address
1030 N ROYAL POINCIANA BLVD, MIAMI SPRINGS, FL 33166-3257
(786) 558-4100
(866) 305-9918
Mailing address
1030 N ROYAL POINCIANA BLVD, MIAMI SPRINGS, FL 33166-3257
(786) 558-4100
(866) 305-9918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1834
FL
Other
Enumeration date
06/08/2013
Last updated
06/08/2013
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