Provider Demographics
NPI:1528403946
Name:PIEDRA, RENE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:
Last Name:PIEDRA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7887 N KENDALL DR.
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7494
Mailing Address - Country:US
Mailing Address - Phone:305-667-6747
Mailing Address - Fax:305-668-1787
Practice Address - Street 1:7887 N KENDALL DR.
Practice Address - Street 2:SUITE 220
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7494
Practice Address - Country:US
Practice Address - Phone:305-667-6747
Practice Address - Fax:305-668-1787
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist