Provider Demographics
NPI:1871796284
Name:MARIAMILAGROS SARDA DDA PA
Entity type:Organization
Organization Name:MARIAMILAGROS SARDA DDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAMILAGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:305-443-4841
Mailing Address - Street 1:299 ALHAMBRA CIRCLE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-443-4841
Mailing Address - Fax:305-443-4808
Practice Address - Street 1:299 ALHAMBRA CIRCLE
Practice Address - Street 2:SUITE 205
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-443-4841
Practice Address - Fax:305-443-4808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12064261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental