Organization
DENTAL PARTNER GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLEN GUTIERREZ DDS (GENERAL DENTIST)
(305) 885-7767
Entity
Organization
Contact information
Practice address
1124 W 29TH ST, HIALEAH, FL 33012-5019
(305) 885-7767
Mailing address
1124 W 29TH ST, HIALEAH, FL 33012-5019
(305) 885-7767
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN20998
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014805301
—
FL
Enumeration date
10/21/2016
Last updated
10/21/2016
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