Provider Demographics
NPI:1033768742
Name:LAS OLAS DENTAL ORTHODONTIC AND IMPLANT CENTER
Entity Type:Organization
Organization Name:LAS OLAS DENTAL ORTHODONTIC AND IMPLANT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:SOLOMON
Authorized Official - Last Name:SEVEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-599-6835
Mailing Address - Street 1:800 E BROWARD BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 E BROWARD BLVD STE 305
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2024
Practice Address - Country:US
Practice Address - Phone:954-859-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental