Organization
EAST COMMERCIAL CHILDRENS DENTAL
Active
Other names
East Commercial Childrens Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT RODRIGUEZ MBA (CEO)
(772) 204-3529
Entity
Organization
Contact information
Practice address
2633 E COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308-4135
(888) 601-4884
Mailing address
801 SE 6TH AVE STE 201, DELRAY BEACH, FL 33483-5185
(772) 204-3529
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154511376
NATIONAL PROVIDER IDENTIFICATION
—
Enumeration date
04/30/2020
Last updated
04/30/2020
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