| Pembroke Pines Dental Health Center, Pa | |
|
1851 Nw 125th Ave #170 Pembroke Pines FL 33028-2596 | |
| (954) 437-2040 | |
| (954) 437-4573 |
| Full Name | Pembroke Pines Dental Health Center, Pa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1851 Nw 125th Ave, Pembroke Pines, Florida |
| Authorized Official Name and Position | John Victor Sootin (OWNER) |
| Authorized Official Contact | 9544372040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pembroke Pines Dental Health Center, Pa 1851 Nw 125 Ave #170 Pembroke Pines FL 33028 Ph: (954) 437-2040 | Pembroke Pines Dental Health Center, Pa 1851 Nw 125th Ave #170 Pembroke Pines FL 33028-2596 Ph: (954) 437-2040 |
| NPI Number | 1679620942 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679620942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DN 16213 (Florida) | Primary |
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