Organization
ICOM CORAL SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA SANTIAGO HERZOG (DENTIST)
(954) 361-0464
Entity
Organization
Contact information
Practice address
5551 N UNIVERSITY DR STE 203, CORAL SPRINGS, FL 33067-4651
(954) 361-0464
(786) 221-4442
Mailing address
611 NE 13TH ST, FT LAUDERDALE, FL 33304-1109
(954) 361-0464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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