| Children's Dental Place Of East Boca,inc | |
|
509 Ne 20th St Boca Raton FL 33431-8141 | |
| (954) 849-4143 | |
| Not Available |
| Full Name | Children's Dental Place Of East Boca,inc |
|---|---|
| Speciality | Dentist |
| Location | 509 Ne 20th St, Boca Raton, Florida |
| Authorized Official Name and Position | Joseph Herman (DENTIST) |
| Authorized Official Contact | 9548494143 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Place Of East Boca,inc 509 Ne 20th St Boca Raton FL 33431-8141 Ph: (954) 849-4143 | Children's Dental Place Of East Boca,inc 509 Ne 20th St Boca Raton FL 33431-8141 Ph: (954) 849-4143 |
| NPI Number | 1538427158 |
|---|---|
| Provider Enumeration Date | 05/02/2012 |
| Last Update Date | 05/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538427158 | NPI | - | NPPES |
| 075515000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN13586 (Florida) | Primary |
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