Individual
VICTOR CELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4461 SHERIDAN ST, HOLLYWOOD, FL 33021-3513
(706) 483-7395
Mailing address
6080 SW 24TH PL APT 307, DAVIE, FL 33314-1152
(706) 483-7395
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN015729
GA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN27779
FL
390200000X
Student in an Organized Health Care Education/Training Program
DN015729
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/18/2018
Last updated
04/12/2023
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