Organization
MAIN STREET CHILDREN'S DENTISTRY AND ORTHODONTICS OF WELLINGTON, PA
Active
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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