NPI 1023381183

Southland Mall Dental,p.A.

Organisation Dentist Cutler Bay, FL

Practice location

Address: 20505 S Dixie Hwy STE 1683, Cutler Bay, FL 33189-1229
Phone: (305) 245-0308
Fax: (954) 846-7170

Authorised official

Name: Rostislav Krasnov
Title: Owner
Phone: (305) 245-0308

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X

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Registry record

NPI: 1023381183
Entity type: Organization
NPI issued: 20 Feb 2012
Record last updated: 3 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.