Provider Demographics
NPI:1437163698
Name:WEISBROT, BRUCE STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:STEVEN
Last Name:WEISBROT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N HIATUS RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-5206
Mailing Address - Country:US
Mailing Address - Phone:954-392-1635
Mailing Address - Fax:954-392-1637
Practice Address - Street 1:700 N HIATUS RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5206
Practice Address - Country:US
Practice Address - Phone:954-392-1635
Practice Address - Fax:954-392-1637
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00097521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice