Provider Demographics
NPI:1306646161
Name:MY BEST FACIAL DESIGN PA
Entity type:Organization
Organization Name:MY BEST FACIAL DESIGN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL&MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-542-4682
Mailing Address - Street 1:1212 COUNTRY CLUB BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2146
Mailing Address - Country:US
Mailing Address - Phone:239-349-7213
Mailing Address - Fax:239-663-0224
Practice Address - Street 1:1212 COUNTRY CLUB BLVD STE 201
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2146
Practice Address - Country:US
Practice Address - Phone:239-349-7213
Practice Address - Fax:239-663-0224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery