Organization
PEMBROKE PINES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN LUIS GARRASTAZU DMD (PRESIDENT)
(954) 431-7199
Entity
Organization
Contact information
Practice address
12311 TAFT ST STE 3, PEMBROKE PINES, FL 33026-4384
(954) 431-7199
(954) 431-9102
Mailing address
12311 TAFT ST STE 3, PEMBROKE PINES, FL 33026-4384
(954) 431-7199
(954) 431-9102
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
FL
Other
Enumeration date
04/12/2007
Last updated
10/18/2010
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