Provider Demographics
NPI:1922325786
Name:DENTAL GROUP OF MIAMI BEACH CORP
Entity Type:Organization
Organization Name:DENTAL GROUP OF MIAMI BEACH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-527-3904
Mailing Address - Street 1:1010 71ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-2963
Mailing Address - Country:US
Mailing Address - Phone:305-868-8500
Mailing Address - Fax:813-933-6417
Practice Address - Street 1:1010 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2963
Practice Address - Country:US
Practice Address - Phone:305-868-8500
Practice Address - Fax:813-933-6417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 16229261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental