Provider Demographics
NPI:1194562876
Name:FLOSS DENTAL GROUP
Entity type:Organization
Organization Name:FLOSS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-709-5006
Mailing Address - Street 1:15600 NW 67TH AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2175
Mailing Address - Country:US
Mailing Address - Phone:786-709-5006
Mailing Address - Fax:
Practice Address - Street 1:15600 NW 67TH AVE STE 106
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2175
Practice Address - Country:US
Practice Address - Phone:786-709-5006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty