Provider Demographics
NPI:1720373889
Name:EXCLUSIVE DENTAL CARE GROUP, INC
Entity Type:Organization
Organization Name:EXCLUSIVE DENTAL CARE GROUP, INC
Other - Org Name:CELIA FIGUEROA DDS PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-392-1942
Mailing Address - Street 1:7150 W 20TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5509
Mailing Address - Country:US
Mailing Address - Phone:305-392-1942
Mailing Address - Fax:305-456-7234
Practice Address - Street 1:7150 W 20TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5509
Practice Address - Country:US
Practice Address - Phone:305-798-4041
Practice Address - Fax:789-442-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL076867700Medicaid