Organization
SAMAR DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS C COLLAZOS D.M.D (DENTIST)
(786) 261-1163
Entity
Organization
Contact information
Practice address
8601 NW 58TH ST UNIT 102, DORAL, FL 33166-3312
(786) 261-1163
Mailing address
8500 SW 109TH AVE APT 212, MIAMI, FL 33173-4458
(786) 261-1163
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20855
FL
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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