Provider Demographics
NPI:1376211060
Name:ARTISA DENTAL
Entity Type:Organization
Organization Name:ARTISA DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEADING DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATUTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-928-9192
Mailing Address - Street 1:1865 N CORPORATE LAKES BLVD STE 2B
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3273
Mailing Address - Country:US
Mailing Address - Phone:954-928-9192
Mailing Address - Fax:954-928-9171
Practice Address - Street 1:1865 N CORPORATE LAKES BLVD STE 2B
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3273
Practice Address - Country:US
Practice Address - Phone:954-928-9192
Practice Address - Fax:954-928-9171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty