Organization
DOCTOR'S DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAUL LIZASO D.M.D (OWNER)
(954) 917-7600
Entity
Organization
Contact information
Practice address
3850 COCONUT CREEK PKWY STE C, COCONUT CREEK, FL 33066-1600
(954) 917-7600
Mailing address
3850 COCONUT CREEK PKWY STE C, COCONUT CREEK, FL 33066-1600
(954) 917-7600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
03/05/2013
Last updated
03/05/2013
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