Provider Demographics
NPI:1285782979
Name:HIALEAH DENTAL HEALTH CENTER
Entity type:Organization
Organization Name:HIALEAH DENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ERRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-821-7811
Mailing Address - Street 1:935 WEST 49 STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:305-821-7811
Mailing Address - Fax:305-821-7255
Practice Address - Street 1:935 W 49TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3436
Practice Address - Country:US
Practice Address - Phone:305-821-7811
Practice Address - Fax:305-821-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN95991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty