Provider Demographics
NPI:1073635694
Name:ARTHUR K MOLZAN DDS PA
Entity Type:Organization
Organization Name:ARTHUR K MOLZAN DDS PA
Other - Org Name:IMPLANT DENTISTRY OF SOUTH FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOLZAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-772-3700
Mailing Address - Street 1:819 DEL PRADO BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990
Mailing Address - Country:US
Mailing Address - Phone:239-772-3700
Mailing Address - Fax:239-574-8444
Practice Address - Street 1:819 DEL PRADO BLVD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990
Practice Address - Country:US
Practice Address - Phone:239-772-3700
Practice Address - Fax:239-574-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T94357Medicare UPIN