Organization
CG COSMETIC DENTAL LLC
Active
Other names
CG Smile
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS IZQUIERDO DMD (VICE PRESIDENT)
(305) 446-7031
Entity
Organization
Contact information
Practice address
2601 SW 37TH AVE STE 702, MIAMI, FL 33133-2750
(305) 446-7031
Mailing address
2601 SW 37TH AVE STE 702, MIAMI, FL 33133-2750
(305) 446-7031
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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