Organization
ALAN D SHOOPAK DMD ORTHODONTIC GROUP II LLC
Active
Organization
ALAN D SHOOPAK DMD ORTHODONTIC GROUP II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN DAVID SHOOPAK (PRESIDENT OWNER)
(727) 561-7666
Entity
Organization
Contact information
Practice address
2161 E COMMERCIAL BLVD, FORT LAUDERDALE, FL 33308-3810
(954) 751-5551
Mailing address
6311 4TH ST N, ST PETERSBURG, FL 33702-7511
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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