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595 S Federal Hwy Ste 130 Boca Raton FL 33432-6096 | |
| (561) 826-7955 | |
| Not Available |
| Full Name | |
|---|---|
| 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 |
|---|---|
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 |
|---|---|
| Provider Enumeration Date | 10/11/2011 |
| Last Update Date | 07/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932483864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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