| Nova Southeastern University, Inc | |
|
3075 Nw 35th Ave Lauderdale Lakes FL 33311-1107 | |
| (954) 739-6233 | |
| (954) 733-9579 |
| Full Name | Nova Southeastern University, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3075 Nw 35th Ave, Lauderdale Lakes, Florida |
| Authorized Official Name and Position | Rober S Oller (CEO CLINICAL OPERATIONS) |
| Authorized Official Contact | 9542624343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Southeastern University, Inc 3200 S. University Drive Sanford L. Ziff Bldg. 3rd Floor Room 4364-d Ft. Lauderdale FL 33328-2018 Ph: (954) 262-4343 | Nova Southeastern University, Inc 3075 Nw 35th Ave Lauderdale Lakes FL 33311-1107 Ph: (954) 739-6233 |
| NPI Number | 1669763462 |
|---|---|
| Provider Enumeration Date | 04/27/2011 |
| Last Update Date | 06/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669763462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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