Organization
WESTLAKE PEDIATRIC DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL DAVID GRUZMARK DMD (OWNER)
(847) 757-8033
Entity
Organization
Contact information
Practice address
4931 SEMINOLE PRATT WHITNEY RD, WESTLAKE, FL 33470-0040
(847) 757-8033
Mailing address
8499 NW 14TH CT, CORAL SPRINGS, FL 33071-6208
(847) 757-8033
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114189300
—
FL
Enumeration date
07/27/2026
Last updated
07/27/2026
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