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Organization
ID III, LLC
Active
Organization
ID III, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ITALO LOZADA DDS (PRESIDENT)
(617) 780-6312
Entity
Organization
Contact information
Practice address
4719 N OCEAN DR, LAUDERDALE BY THE SEA, FL 33308-2914
(954) 933-5937
Mailing address
4719 N OCEAN DR, LAUDERDALE BY THE SEA, FL 33308-2914
(954) 933-5937
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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