Provider Demographics
NPI:1376177618
Name:WILLIAM FORERO DMD PA
Entity Type:Organization
Organization Name:WILLIAM FORERO DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FORERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-752-4900
Mailing Address - Street 1:3000 N UNIVERSITY DR STE P
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5082
Mailing Address - Country:US
Mailing Address - Phone:549-752-4900
Mailing Address - Fax:
Practice Address - Street 1:3000 N UNIVERSITY DR STE P
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5082
Practice Address - Country:US
Practice Address - Phone:549-752-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty