Individual
DR. GARY S KODISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11536 PALLAS DR, BOYNTON BEACH, FL 33437-6427
(954) 554-4480
Mailing address
11536 PALLAS DR, BOYNTON BEACH, FL 33437-6427
(954) 554-4480
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8205
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
592018927
FED TAX ID
FL
Enumeration date
04/06/2007
Last updated
06/26/2026
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