Provider Demographics
NPI:1821725383
Name:DENTAL IMPLANT 24HRS SOUTH MIAMI
Entity Type:Organization
Organization Name:DENTAL IMPLANT 24HRS SOUTH MIAMI
Other - Org Name:DR IMPLANT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-683-0698
Mailing Address - Street 1:1525 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3312
Mailing Address - Country:US
Mailing Address - Phone:786-683-0698
Mailing Address - Fax:
Practice Address - Street 1:6280 SUNSET DR STE 401
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4860
Practice Address - Country:US
Practice Address - Phone:305-423-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty