Organization
PERIODONTICS AND IMPLANTOLOGY OF PEMBROKE PINES
Active
Other names
Periodontology and Implants of Pembroke Pines
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENISE ANNE BRADY DDS (PRESIDENT/OWNER)
(954) 517-1721
Entity
Organization
Contact information
Practice address
700 N HIATUS RD, #201, PEMBROKE PINES, FL 33026-5206
(954) 517-1721
(954) 436-3628
Mailing address
700 N HIATUS RD, #201, PEMBROKE PINES, FL 33026-5206
(954) 517-1721
(954) 436-3628
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN 14692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN14692
FLORIDA DENTAL LICENCE
FL
Enumeration date
10/24/2006
Last updated
08/22/2020
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