Organization
HALLANDALE DENTAL GROUP, LLC
Active
Other names
Under 21
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID JOHANNA ROMERO DMD (OWNER)
(954) 718-3384
Entity
Organization
Contact information
Practice address
200 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009-5525
(954) 718-3384
(561) 431-2468
Mailing address
200 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009-5525
(954) 718-3384
(561) 431-2468
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972807204
NPI TYPE 1
FL
Enumeration date
04/15/2020
Last updated
04/15/2020
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