Organization
FLORIDA CENTER FOR ORAL SURGERY & DENTAL IMPLANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAMONE E SMITH D.D.S. (PRESIDENT)
(954) 845-0098
Entity
Organization
Contact information
Practice address
12651 W SUNRISE BLVD, SUITE 304, SUNRISE, FL 33323-0906
(954) 845-0098
(954) 845-0280
Mailing address
12651 W SUNRISE BLVD, SUITE 304, SUNRISE, FL 33323-0906
(954) 845-0098
(954) 845-0280
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN16488
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690057701
—
FL
05
—
690057796
—
FL
Enumeration date
02/19/2014
Last updated
02/19/2014
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