Provider Demographics
NPI:1063457307
Name:GEWARTOWSKI, DANIEL E (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:GEWARTOWSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N MILITARY TRL
Mailing Address - Street 2:STE 348
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6312
Mailing Address - Country:US
Mailing Address - Phone:561-241-7272
Mailing Address - Fax:561-241-4986
Practice Address - Street 1:2600 N MILITARY TRL
Practice Address - Street 2:STE 348
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6312
Practice Address - Country:US
Practice Address - Phone:561-241-7272
Practice Address - Fax:561-241-4986
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN5713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist