Provider Demographics
NPI:1790388155
Name:LAND OF SMILES P.A.
Entity type:Organization
Organization Name:LAND OF SMILES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:LANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-436-0502
Mailing Address - Street 1:6505 SW 20TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5147
Mailing Address - Country:US
Mailing Address - Phone:786-488-3796
Mailing Address - Fax:
Practice Address - Street 1:18503 PINES BLVD STE 209
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1405
Practice Address - Country:US
Practice Address - Phone:954-436-0502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty