Organization
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WELLINGTON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (PROVIDER RELATIONS)
(305) 274-2499
Entity
Organization
Contact information
Practice address
11903 SOUTHERN BLVD., SUITE #102, ROYAL PALM BEACH, FL 33411
(561) 422-2940
(561) 422-2945
Mailing address
13195 SW 134 ST, 2ND FLOOR, MIAMI, FL 33186
(305) 274-2499
(561) 422-2945
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
FL
Other
Enumeration date
06/18/2007
Last updated
08/20/2014
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