| Perio Doctor Llc | |
|
1312 E Broward Blvd Fort Lauderdale FL 33301-2136 | |
| (786) 449-4262 | |
| Not Available |
| Full Name | Perio Doctor Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1312 E Broward Blvd, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Vanessa Lynn Mancuso (OWNER) |
| Authorized Official Contact | 7864494262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Perio Doctor Llc 1312 E Broward Blvd Fort Lauderdale FL 33301-2136 Ph: () - | Perio Doctor Llc 1312 E Broward Blvd Fort Lauderdale FL 33301-2136 Ph: (786) 449-4262 |
| NPI Number | 1881440105 |
|---|---|
| Provider Enumeration Date | 04/26/2024 |
| Last Update Date | 04/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881440105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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