Provider Demographics
NPI:1376859157
Name:NEW DENTAL CARE
Entity Type:Organization
Organization Name:NEW DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZUZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-649-9443
Mailing Address - Street 1:285 NW 27 AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-649-9443
Mailing Address - Fax:305-640-8347
Practice Address - Street 1:285 NW 27 AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-649-9443
Practice Address - Fax:305-640-8347
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW DENTAL CARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18673122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty