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Organization
PALM BEACH MALL DENTAL, PA
Active
Organization
PALM BEACH MALL DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSTISLAV KRASNOV DDS (OWNER)
(561) 683-6247
Entity
Organization
Contact information
Practice address
1801 PALM BEACH LAKES BLVD, WEST PALM BEACH, FL 33401-2020
(561) 683-6247
(561) 683-6248
Mailing address
1801 PALM BEACH LAKES BLVD, WEST PALM BEACH, FL 33401-2020
(561) 683-6247
(561) 683-6248
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
12/03/2018
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