Organization
LUIS F GOMEZ DDS PA
Active
Parent organization
LUIS F GOMEZ DDS PA
Other names
Complete Dental Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUIS F GOMEZ DDS PA
Authorized official
MRS. OLGA GOMEZ (OFFICE MANAGER)
(954) 649-1054
Entity
Organization
Contact information
Practice address
4651 N STATE ROAD 7 STE 4, COCONUT CREEK, FL 33073-4378
(954) 510-4300
Mailing address
4651 N STATE ROAD 7 STE 4, COCONUT CREEK, FL 33073-4378
(954) 510-4300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689899452
—
FL
Enumeration date
04/01/2021
Last updated
04/01/2021
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