| Organization Name: | DENTAL ASSOCIATES OF BAL HARBOUR |
| NPI Number: | 1295977015 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALFREDO DOMINGO CORPAS (DENTIST/OWNER) |
| Mailing Address: | 260 95th St Suite 209 Surfside |
| State: | FL US |
| Postal Code: | 331542807 |
| Phone Number: | 3058668290 |
| Fax Number: | 3058668298 |
| NPI Enumeration Date: | 03/25/2009 |
| NPI Last Update Date: | 03/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN0013451 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |