| Broward Periodontics Pa | |
|
1027 Se 17th St Ft Lauderdale FL 33316-2116 | |
| (954) 916-7664 | |
| (954) 916-7647 |
| Full Name | Broward Periodontics Pa |
|---|---|
| Speciality | Dentist |
| Location | 1027 Se 17th St, Ft Lauderdale, Florida |
| Authorized Official Name and Position | Christopher Deture (DOCTOR/OWNER) |
| Authorized Official Contact | 9549167664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broward Periodontics Pa 1027 Se 17th St Ft Lauderdale FL 33316-2116 Ph: (954) 916-7664 | Broward Periodontics Pa 1027 Se 17th St Ft Lauderdale FL 33316-2116 Ph: (954) 916-7664 |
| NPI Number | 1639624539 |
|---|---|
| Provider Enumeration Date | 08/20/2016 |
| Last Update Date | 08/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639624539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN14431 (Florida) | Primary |
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