Organization
LIFESTYLE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TATIANA SANTIAGO-HERZOG DDS (DENTIST)
(561) 750-6790
Entity
Organization
Contact information
Practice address
3401 N FEDERAL HWY, 101, BOCA RATON, FL 33431-6046
(561) 750-6790
(561) 750-0535
Mailing address
3401 N FEDERAL HWY, 101, BOCA RATON, FL 33431-6046
(561) 750-6790
(561) 750-0535
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN18993
FL
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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