NPI | 1053423475 |
---|---|
Doing Business As | MAIN STREET CHILDREN'S DENTISTRY OF KENDALL |
Entity Type | Organization |
Authorized Contact | STEPHANIE GOMEZ Provider Relations 305-274-2499 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2006-08-31 |
Last Update Date | 2014-08-12 |