Provider Demographics
NPI:1164850442
Name:K & K DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:K & K DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-225-5050
Mailing Address - Street 1:2600 NW 87TH AVE
Mailing Address - Street 2:SUITE 29
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1621
Mailing Address - Country:US
Mailing Address - Phone:305-225-5050
Mailing Address - Fax:305-593-8825
Practice Address - Street 1:2600 NW 87TH AVE
Practice Address - Street 2:SUITE 29
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1621
Practice Address - Country:US
Practice Address - Phone:305-225-5050
Practice Address - Fax:305-593-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 19261122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty