Provider Demographics
NPI:1619924552
Name:POINTE ROYALE DENTAL CLINIC
Entity Type:Organization
Organization Name:POINTE ROYALE DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FURNAGUERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-829-7796
Mailing Address - Street 1:19151 S DIXIE HWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7737
Mailing Address - Country:US
Mailing Address - Phone:305-256-1303
Mailing Address - Fax:305-256-8707
Practice Address - Street 1:19151 S DIXIE HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-7737
Practice Address - Country:US
Practice Address - Phone:305-256-1303
Practice Address - Fax:305-256-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL370297-5261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental