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Organization
EAST COMMERCIAL CHILDRENS DENTAL
Active
Organization
EAST COMMERCIAL CHILDRENS DENTAL
Active
Other names
East Commercial Childrens Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT RODRIGUEZ MBA (CEO)
(772) 204-3529
Entity
Organization
Contact information
Practice address
2633 E COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308-4135
(888) 601-4884
Mailing address
801 SE 6TH AVE STE 201, DELRAY BEACH, FL 33483-5185
(772) 204-3529
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154511376
NATIONAL PROVIDER IDENTIFICATION
—
Enumeration date
04/30/2020
Last updated
04/30/2020
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