Provider Demographics
NPI:1134503329
Name:GRANADA-RAMIREZ, ERIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:
Last Name:GRANADA-RAMIREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6617 WINFIELD BLVD
Mailing Address - Street 2:UNIT 7
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-7192
Mailing Address - Country:US
Mailing Address - Phone:954-326-6265
Mailing Address - Fax:
Practice Address - Street 1:4911 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-2926
Practice Address - Country:US
Practice Address - Phone:561-582-5273
Practice Address - Fax:561-582-5255
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21446122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist