Organization
BROWARD ORAL SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAITH AZZOUNI (OWNER)
(954) 431-1600
Entity
Organization
Contact information
Practice address
3157 N UNIVERSITY DR STE 104, PEMBROKE PINES, FL 33024-2258
(954) 431-1600
(954) 432-7994
Mailing address
3157 N UNIVERSITY DR STE 104, PEMBROKE PINES, FL 33024-2258
(954) 431-1600
(954) 432-7994
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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