Organization
DENTASTIC DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL SHEPARD PA (MANAGER)
(954) 464-1098
Entity
Organization
Contact information
Practice address
31 SE 24TH AVE STE 3, POMPANO BEACH, FL 33062-5347
(954) 781-4670
Mailing address
31 SE 24TH AVE STE 3, POMPANO BEACH, FL 33062-5347
(954) 781-4670
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 18328
FL
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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