Provider Demographics
NPI:1801984869
Name:RENE PIEDRA DMD AND ASSOCIATES PA
Entity type:Organization
Organization Name:RENE PIEDRA DMD AND ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:I
Authorized Official - Last Name:PIEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-667-6747
Mailing Address - Street 1:7887 N KENDALL DR.
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7494
Mailing Address - Country:US
Mailing Address - Phone:305-667-6747
Mailing Address - Fax:305-668-1787
Practice Address - Street 1:7887 N KENDALL DR.
Practice Address - Street 2:SUITE 220
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7494
Practice Address - Country:US
Practice Address - Phone:305-667-6747
Practice Address - Fax:305-668-1787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0014523261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental