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Organization

DORAL DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KERRY DAVID SMITH D.M.D (DENTIST AND OWNER)
(305) 477-7601
Entity
Organization

Contact information

Practice address
10818 NW 58TH ST, DORAL, FL 33178-2854
(305) 477-7601
(305) 471-0137
Mailing address
10818 NW 58TH ST, DORAL, FL 33178-2854
(305) 477-7601
(305) 471-0137

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN 14900
FL
122300000X
Dentist
Primary
DN11702
FL
122300000X
Dentist
DN13223
FL
122300000X
Dentist
DN14811
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
056546939
DENTIST
FL
01
595303579
DENTIST
FL
01
650561621
DENTIST
FL
Enumeration date
11/08/2006
Last updated
07/13/2009
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