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595 S Federal Hwy Ste 130 Boca Raton FL 33432-6096 | |
(561) 826-7955 | |
Not Available |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 595 S Federal Hwy Ste 130, Boca Raton, Florida |
Authorized Official Name and Position | Melvyn Gober (CEO) |
Authorized Official Contact | 3052742499 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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13195 Sw 134th St Fl 2 Miami FL 33186-4461 Ph: (305) 274-2499 | 595 S Federal Hwy Ste 130 Boca Raton FL 33432-6096 Ph: (561) 826-7955 |
NPI Number | 1932483864 |
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Provider Enumeration Date | 10/11/2011 |
Last Update Date | 07/10/2012 |
Identifier | Type | State | Issuer |
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1932483864 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Secondary |
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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