Organization
CORAL RIDGE SMILE
Active
Parent organization
MANDANA INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MANDANA INC.
Authorized official
DR. MANDANA MIR ESMAILI D.D.S. (OWNER)
(954) 990-6543
Entity
Organization
Contact information
Practice address
2324 NE 53RD ST, FT LAUDERDALE, FL 33308-3212
(954) 990-6543
(954) 491-4876
Mailing address
2324 NE 53RD ST., FT. LAUDERDALE, FL 33308
(954) 990-6543
(954) 941-4876
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/02/2007
Last updated
02/16/2012
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