Provider Demographics
NPI:1962364240
Name:ESTHETIC ART DENTAL LLC
Entity type:Organization
Organization Name:ESTHETIC ART DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:YGLESIAS RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-509-5857
Mailing Address - Street 1:2500 SW 107 AVE
Mailing Address - Street 2:SUITE # 35&36
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165
Mailing Address - Country:US
Mailing Address - Phone:305-509-5857
Mailing Address - Fax:305-509-5856
Practice Address - Street 1:2500 SW 107 AVE
Practice Address - Street 2:SUITE35&36
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165
Practice Address - Country:US
Practice Address - Phone:305-509-5857
Practice Address - Fax:305-509-5856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty