Organization
PEDIATRIC AND ORTHODONTIC DENTAL CENTERS OF BROWARD
Active
Other names
Pediatric Dental Centers of Broward
Organization subpart
No
Provider details
NPI number
Authorized official
ENRIQUE ACOSTA DDS (PEDIATRIC DENTIST)
(954) 341-0002
Entity
Organization
Contact information
Practice address
8351 W ATLANTIC BLVD, CORAL SPRINGS, FL 33071-7454
(954) 341-0002
Mailing address
8351 W ATLANTIC BLVD, CORAL SPRINGS, FL 33071-7454
(954) 341-0002
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN17284
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076110900
—
FL
05
—
076240700
—
FL
05
—
076721200
—
FL
Enumeration date
05/01/2007
Last updated
03/17/2009
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