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Organization

DENTAL SPECIALISTS OF PEMBROKE PINES GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IVAN PELTON DDS (CLINICAL DIRECTOR)
(305) 220-8911
Entity
Organization

Contact information

Practice address
12558 PINES BLVD, PEMBROKE PINES, FL 33027-1713
(305) 220-8911
Mailing address
12558 PINES BLVD, PEMBROKE PINES, FL 33027-1713

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN5838
FL

Other

Enumeration date
08/24/2017
Last updated
08/24/2017
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