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17027 Pines Blvd Pembroke Pines FL 33027-1003 | |
| (954) 704-0044 | |
| (954) 704-8302 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17027 Pines Blvd, Pembroke Pines, Florida |
| Authorized Official Name and Position | Joshua Bockian (CO-OWNER) |
| Authorized Official Contact | 9547040044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1550 Breakwater Ter Hollywood FL 33019-5023 Ph: (954) 704-0044 | 17027 Pines Blvd Pembroke Pines FL 33027-1003 Ph: (954) 704-0044 |
| NPI Number | 1578630042 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578630042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN6296 (Florida) | Primary |
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