Provider Demographics
NPI:1750842803
Name:DENTAL GROUP OF KENDALL INC
Entity type:Organization
Organization Name:DENTAL GROUP OF KENDALL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALINDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-290-0986
Mailing Address - Street 1:11410 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1031
Mailing Address - Country:US
Mailing Address - Phone:305-595-4117
Mailing Address - Fax:
Practice Address - Street 1:11410 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1031
Practice Address - Country:US
Practice Address - Phone:305-595-4117
Practice Address - Fax:305-595-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental