# CHILDREN'S DENTAL PLACE OF EAST BOCA,INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538427158
- **Authorized official:** DR. JOSEPH HERMAN (DENTIST)
- **Authorized official phone:** (954) 849-4143

## Contact information

- **Practice address:** 509 NE 20TH ST, BOCA RATON, FL 33431-8141
- **Practice address phone:** (954) 849-4143
- **Mailing address:** 509 NE 20TH ST, BOCA RATON, FL 33431-8141
- **Mailing address phone:** (954) 849-4143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DN13586 | FL | Yes |

## Other

- **Enumeration date:** 05/02/2012
- **Last updated:** 05/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 075515000 | — | FL |