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916 Sw 15 Street Deerfield Beach FL 33441 | |
| (754) 322-0712 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 916 Sw 15 Street, Deerfield Beach, Florida |
| Authorized Official Name and Position | Frank P Nask (SR VICE PRESIDENT CFO) |
| Authorized Official Contact | 9543555064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 862851 Orlando FL 32886-2851 Ph: (954) 847-4273 | 916 Sw 15 Street Deerfield Beach FL 33441 Ph: (754) 322-0712 |
| NPI Number | 1437187481 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 09/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437187481 | NPI | - | NPPES |
| 00020 | Other | FL | BCBS OF FLA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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