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9497 Old Pine Rd Boca Raton FL 33428-3055 | |
| (305) 336-4515 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 9497 Old Pine Rd, Boca Raton, Florida |
| Authorized Official Name and Position | Sean Shkolnik (DENTIST) |
| Authorized Official Contact | 3053364515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
9497 Old Pine Rd Boca Raton FL 33428-3055 Ph: (305) 336-4515 | 9497 Old Pine Rd Boca Raton FL 33428-3055 Ph: (305) 336-4515 |
| NPI Number | 1508439050 |
|---|---|
| Provider Enumeration Date | 07/22/2021 |
| Last Update Date | 11/04/2021 |
| Medicare PECOS PAC ID | 7315336724 |
|---|---|
| Medicare Enrollment ID | O20211104003087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508439050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Sean Shkolnik |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1730589474 PECOS PAC ID: 5597154906 Enrollment ID: I20211104003136 |
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