Organization
GROSMAN PEDIATRIC DENTISTRY AND ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA MARRANZINI-GROSMAN (OWNER)
(954) 236-3434
Entity
Organization
Contact information
Practice address
4401 S FLAMINGO RD, STE 109, DAVIE, FL 33330-1914
(954) 236-3434
(954) 236-3405
Mailing address
4401 S FLAMINGO RD, STE 109, DAVIE, FL 33330-1914
(954) 236-3434
(954) 236-3405
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN 15203
FL
1223P0221X
Pediatric Dentistry
DN20826
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D15664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427345057
INDIVIDUAL NPI
FL
01
—
1548392889
INDIVIDUAL NPI
FL
01
—
1740354174
INDIVIDUAL NPI
FL
Enumeration date
10/19/2015
Last updated
10/19/2015
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