| Pedo Ortho Dental Specialists Llc | |
|
8950 Sw 74th Ct Ste 124 Miami FL 33156-3171 | |
| (954) 268-9825 | |
| Not Available |
| Full Name | Pedo Ortho Dental Specialists Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 8950 Sw 74th Ct Ste 124, Miami, Florida |
| Authorized Official Name and Position | Stephen Criscuolo (DMD/OWNER) |
| Authorized Official Contact | 9542689825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pedo Ortho Dental Specialists Llc 8950 Sw 74th Ct Ste 124 Miami FL 33156-3171 Ph: () - | Pedo Ortho Dental Specialists Llc 8950 Sw 74th Ct Ste 124 Miami FL 33156-3171 Ph: (954) 268-9825 |
| NPI Number | 1538673975 |
|---|---|
| Provider Enumeration Date | 11/21/2017 |
| Last Update Date | 11/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538673975 | NPI | - | NPPES |
| 008662900 | Medicaid | FL | |
| 019273100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN21814 (Florida) | Primary |
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