Provider Demographics
NPI:1194180851
Name:SHAFFREN DENTAL CARE
Entity Type:Organization
Organization Name:SHAFFREN DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFREN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-737-3200
Mailing Address - Street 1:1700 W WOOLBRIGHT RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-6346
Mailing Address - Country:US
Mailing Address - Phone:561-737-3200
Mailing Address - Fax:561-364-9775
Practice Address - Street 1:1700 W WOOLBRIGHT RD STE 2
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6346
Practice Address - Country:US
Practice Address - Phone:561-737-3200
Practice Address - Fax:561-364-9775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty