Organization
DENTAL LAS OLAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NADEZDA SELMIC DMD (PRESIDENT)
(617) 818-4596
Entity
Organization
Contact information
Practice address
401 E LAS OLAS BLVD, SUITE #140, FORT LAUDERDALE, FL 33301-2210
(954) 524-6595
Mailing address
900 NE 12TH AVE, APT 602, HALLANDALE BEACH, FL 33009-2655
(617) 818-4596
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20436
FL
Other
Enumeration date
11/22/2013
Last updated
11/22/2013
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