Provider Demographics
NPI:1518370071
Name:JAVIER M ZAWADZKY D.M.D, PA
Entity Type:Organization
Organization Name:JAVIER M ZAWADZKY D.M.D, PA
Other - Org Name:LIFE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:MAURICIO
Authorized Official - Last Name:ZAWADZKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-600-6839
Mailing Address - Street 1:1171 NW 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-7817
Mailing Address - Country:US
Mailing Address - Phone:954-600-6839
Mailing Address - Fax:954-429-8842
Practice Address - Street 1:123 N POWERLINE RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-8037
Practice Address - Country:US
Practice Address - Phone:954-429-8840
Practice Address - Fax:954-429-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN190981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty