Provider Demographics
NPI:1578675088
Name:CHILDREN'S DENTAL TEAM
Entity Type:Organization
Organization Name:CHILDREN'S DENTAL TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINARES
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:305-274-2499
Mailing Address - Street 1:8966 SW 87TH CT STE 1B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2273
Mailing Address - Country:US
Mailing Address - Phone:305-598-5405
Mailing Address - Fax:
Practice Address - Street 1:8966 SW 87TH CT STE 1B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2273
Practice Address - Country:US
Practice Address - Phone:305-598-5405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty