Organization
CL DDS 2 PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG LUSTMAN DDS (OWNER)
(954) 255-2787
Entity
Organization
Contact information
Practice address
9156 WILES RD, CORAL SPRINGS, FL 33067-1999
(954) 255-2787
Mailing address
3320 SW 58TH ST, FT LAUDERDALE, FL 33312-6365
(443) 235-2403
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/19/2020
Last updated
07/19/2020
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