Organization
MIAMI CHILDREN'S HOSPITAL
Active
Other names
MCH ToothTown
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW A LOVE (PRESIDENT & CEO)
(305) 666-6511
Entity
Organization
Contact information
Practice address
3601 NW 107TH AVE, DORAL, FL 33178-4377
(305) 663-8538
(305) 662-8314
Mailing address
3601 NW 107TH AVE, DORAL, FL 33178-4377
(305) 663-8538
(305) 662-8314
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
574498-3
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074560000
—
FL
Enumeration date
06/12/2006
Last updated
09/15/2023
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