Provider Demographics
NPI:1043829377
Name:LITTLE CHAMPIONS PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:LITTLE CHAMPIONS PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:ABARCA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-778-4722
Mailing Address - Street 1:1330 SW 22ND ST STE 406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2945
Mailing Address - Country:US
Mailing Address - Phone:305-778-4722
Mailing Address - Fax:
Practice Address - Street 1:1330 SW 22ND ST STE 406
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2945
Practice Address - Country:US
Practice Address - Phone:305-778-4722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty