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Individual

DR. DEEPALI NILESH JETHWA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1209 W BROWARD BLVD, FORT LAUDERDALE, FL 33312-1640
(954) 763-3358
Mailing address
20904 AVENEL RUN, BOCA RATON, FL 33428-1222
(561) 479-2817

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16368
FL

Other

Enumeration date
01/08/2007
Last updated
07/08/2007
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