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1104417153
MODERNA SMILE OF GALLOWAY CORP
MIAMI, FL
NPI
1104417153
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Entity Type
Organization
Authorized Contact
JUAN CARLOS IZQUIERDO
President
305-273-9330
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2021-02-02
Last Update Date
2021-02-02
Business Address
MODERNA SMILE OF GALLOWAY CORP
8718 SW 72ND ST
MIAMI, FL 33173-3512
Phone number: 305-273-9330
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Mailing Address
MODERNA SMILE OF GALLOWAY CORP
5246 SW 8TH ST
CORAL GABLES, FL 33134-2375
Phone number:
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