Provider Demographics
NPI:1679844450
Name:UNIQUE DENTAL TEAM
Entity Type:Organization
Organization Name:UNIQUE DENTAL TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-344-3881
Mailing Address - Street 1:10511 SW 88TH ST
Mailing Address - Street 2:SUITE C101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1535
Mailing Address - Country:US
Mailing Address - Phone:305-821-3344
Mailing Address - Fax:305-821-3311
Practice Address - Street 1:10511 SW 88TH ST
Practice Address - Street 2:SUITE C101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1535
Practice Address - Country:US
Practice Address - Phone:305-821-3344
Practice Address - Fax:305-821-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13222261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental