Provider Demographics
NPI:1922781319
Name:BR DENTAL SERVICES LLC
Entity Type:Organization
Organization Name:BR DENTAL SERVICES LLC
Other - Org Name:THE SMILE CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:DR
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOHORQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-404-9937
Mailing Address - Street 1:3695 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4839
Mailing Address - Country:US
Mailing Address - Phone:305-404-9937
Mailing Address - Fax:305-404-9938
Practice Address - Street 1:3695 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4839
Practice Address - Country:US
Practice Address - Phone:305-404-9937
Practice Address - Fax:305-404-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental