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Organization
NOVA DENTAL INC
Active
Organization
NOVA DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANTIAGO ROLDAN DMD (OWNER)
(954) 825-9128
Entity
Organization
Contact information
Practice address
1501 SE 23RD AVE, POMPANO BEACH, FL 33062-7507
(954) 825-9128
Mailing address
1501 SE 23RD AVE, POMPANO BEACH, FL 33062-7507
(954) 825-9128
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15793
FL
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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