Organization
MAIN STREET ORTHODONTICS OF MIAMI LAKES, PA
Active
Other names
Main Street Children's Dentistry of Miami Lakes
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GOMEZ (PROVIDER RELATIONS)
(305) 274-2499
Entity
Organization
Contact information
Practice address
15600 NW 67 AVE, SUITE 110, MIAMI LAKES, FL 33014
(305) 823-8831
Mailing address
13195 SW 134 ST, 2ND FLOOR, MIAMI, FL 33186
(305) 274-2499
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/21/2014
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