Organization
LAURIE B. GITTESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY M DURAN (OFFICE MANAGER)
(954) 389-2345
Entity
Organization
Contact information
Practice address
1625 N COMMERCE PKWY, STE 317, WESTON, FL 33326-3216
(954) 389-2345
Mailing address
1625 N COMMERCE PKWY, STE 317, WESTON, FL 33326-3216
(954) 389-2345
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19566
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13474
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007987200
—
FL
05
—
010596200
—
FL
Enumeration date
07/09/2015
Last updated
07/09/2015
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