Provider Demographics
NPI:1174666481
Name:REZK, AURORE (DMD)
Entity Type:Individual
Prefix:DR
First Name:AURORE
Middle Name:
Last Name:REZK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 VIRGINIA AVE
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-5882
Mailing Address - Country:US
Mailing Address - Phone:772-461-4330
Mailing Address - Fax:772-461-9518
Practice Address - Street 1:900 VIRGINIA AVE
Practice Address - Street 2:SUITE # 4
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-5882
Practice Address - Country:US
Practice Address - Phone:772-461-4330
Practice Address - Fax:772-461-9518
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN147771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice