Organization Name: | BILTMORE DENTAL ASSOCIATES P.A. |
NPI Number: | 1114169505 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDRYS B LEYVA (GENERAL MANAGER) |
Mailing Address: | 11300 Nw 87th Ct Suite#166 Hialeah Gardens |
State: | FL US |
Postal Code: | 330184586 |
Phone Number: | 3053649322 |
Fax Number: | 3053640983 |
NPI Enumeration Date: | 03/31/2009 |
NPI Last Update Date: | 03/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |