Provider Demographics
NPI:1811201460
Name:TRATAMIENTOS DENTALES INC
Entity Type:Organization
Organization Name:TRATAMIENTOS DENTALES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLINA
Authorized Official - Suffix:
Authorized Official - Credentials:DA
Authorized Official - Phone:305-649-5710
Mailing Address - Street 1:285 NW 27TH AVE STE 19
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-5133
Mailing Address - Country:US
Mailing Address - Phone:305-649-5710
Mailing Address - Fax:305-649-5710
Practice Address - Street 1:285 NW 27TH AVE STE 19
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5133
Practice Address - Country:US
Practice Address - Phone:305-649-5710
Practice Address - Fax:305-649-5710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL132111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty