Organization
MODERNA SMILE OF KENDALL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS IZQUIERDO DMD (PRESIDENT)
(305) 385-1442
Entity
Organization
Contact information
Practice address
13632 N KENDALL DR, MIAMI, FL 33186-1567
(305) 385-1442
Mailing address
5246 SW 8TH ST, CORAL GABLES, FL 33134-2375
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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