Organization
ACDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRY GORBATOV PHS,DDS (OWNER)
(561) 721-9777
Entity
Organization
Contact information
Practice address
12012 S SHORE BLVD, SUITE 211, WELLINGTON, FL 33414-6203
(561) 721-9777
(561) 721-9778
Mailing address
12012 S SHORE BLVD, SUITE 211, WELLINGTON, FL 33414-6203
(561) 721-9777
(561) 721-9778
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15160
FL
Other
Enumeration date
12/22/2010
Last updated
12/22/2010
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