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Organization

PRIME PEDIATRIC DENTAL GROUP PA

Active
Parent organization
PRIME PEDIATRIC DENTAL GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
PRIME PEDIATRIC DENTAL GROUP
Authorized official
DR. JOSE MELLADO DMD (PRESIDENT)
(305) 321-3790
Entity
Organization

Contact information

Practice address
4410 W 16TH AVE STE 52, HIALEAH, FL 33012-7193
(305) 251-5390
Mailing address
4410 W 16TH AVE STE 52, HIALEAH, FL 33012-7193

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
09/25/2024
Last updated
09/30/2024
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