| Pompano Beach Periodontics Pllc | |
|
2231 Ne 25th Ave Suite 4 Pompano Beach FL 33062-1148 | |
| (954) 782-7911 | |
| (954) 782-7925 |
| Full Name | Pompano Beach Periodontics Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2231 Ne 25th Ave, Pompano Beach, Florida |
| Authorized Official Name and Position | Jason A Witonsky (MANAGINGMEMBER) |
| Authorized Official Contact | 9547827911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pompano Beach Periodontics Pllc 2231 Ne 25th Ave Suite 4 Pompano Beach FL 33062-1148 Ph: (954) 782-7911 | Pompano Beach Periodontics Pllc 2231 Ne 25th Ave Suite 4 Pompano Beach FL 33062-1148 Ph: (954) 782-7911 |
| NPI Number | 1972930774 |
|---|---|
| Provider Enumeration Date | 10/11/2013 |
| Last Update Date | 10/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972930774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DN18938 (Florida) | Primary |
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