Organization
BRUSH CORAL SPRINGS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY ANN SWEENEY (PRACTICE ADMINISTRATOR)
(954) 753-1600
Entity
Organization
Contact information
Practice address
961 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-7048
(954) 753-1600
(954) 753-6609
Mailing address
961 N UNIVERSITY DR, CORAL SPRINGS, FL 33071-7048
(954) 753-1600
(954) 753-6609
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
DN14279
FL
261QD0000X
Dental Clinic/Center
Primary
DN19814
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456789
GENERAL
—
Enumeration date
11/14/2017
Last updated
11/14/2017
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