Provider Demographics
NPI:1467883322
Name:DENTALWORKS STUDIO OF WEST PALM BEACH PA
Entity Type:Organization
Organization Name:DENTALWORKS STUDIO OF WEST PALM BEACH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-274-0406
Mailing Address - Street 1:660 LINTON BLVD
Mailing Address - Street 2:SUITE 111B
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-8167
Mailing Address - Country:US
Mailing Address - Phone:561-274-0406
Mailing Address - Fax:
Practice Address - Street 1:6336 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33415-6104
Practice Address - Country:US
Practice Address - Phone:561-642-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 188351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty