Provider Demographics
NPI:1114131505
Name:FRANK L GOBER DDS PA
Entity Type:Organization
Organization Name:FRANK L GOBER DDS PA
Other - Org Name:DEERFIELD DENTAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-427-4321
Mailing Address - Street 1:1800 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DEERFIELD BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33442
Mailing Address - Country:US
Mailing Address - Phone:954-427-4321
Mailing Address - Fax:954-427-2385
Practice Address - Street 1:1800 W HILLSBORO BLVD
Practice Address - Street 2:STE 210
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1484
Practice Address - Country:US
Practice Address - Phone:954-427-4321
Practice Address - Fax:954-427-2385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty