Provider Demographics
NPI:1326269549
Name:SMILES OF KENDALL FAMILY DENTAL, INC
Entity Type:Organization
Organization Name:SMILES OF KENDALL FAMILY DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIO-PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-388-7676
Mailing Address - Street 1:13045 SW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4601
Mailing Address - Country:US
Mailing Address - Phone:305-388-7676
Mailing Address - Fax:305-388-7919
Practice Address - Street 1:13045 SW 112TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4601
Practice Address - Country:US
Practice Address - Phone:305-388-7676
Practice Address - Fax:305-388-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15736122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty