| Tooth Fairy Dental I Llc | |
|
15495 Eagle Nest Ln Ste 110 Miami Lakes FL 33014-2242 | |
| (561) 891-9046 | |
| Not Available |
| Full Name | Tooth Fairy Dental I Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15495 Eagle Nest Ln Ste 110, Miami Lakes, Florida |
| Authorized Official Name and Position | Scott Spencer (OWNER) |
| Authorized Official Contact | 5618919046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth Fairy Dental I Llc 15495 Eagle Nest Ln Ste 110 Miami Lakes FL 33014-2242 Ph: (561) 891-9046 | Tooth Fairy Dental I Llc 15495 Eagle Nest Ln Ste 110 Miami Lakes FL 33014-2242 Ph: (561) 891-9046 |
| NPI Number | 1487308201 |
|---|---|
| Provider Enumeration Date | 02/10/2022 |
| Last Update Date | 02/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487308201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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