Provider Demographics
NPI:1568576676
Name:SORIN DIMITRIU DDS PA
Entity Type:Organization
Organization Name:SORIN DIMITRIU DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SORIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMITRIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-420-0551
Mailing Address - Street 1:1500 E HILLSBORO BLVD
Mailing Address - Street 2:SUITE #208
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4355
Mailing Address - Country:US
Mailing Address - Phone:954-420-0551
Mailing Address - Fax:954-420-0073
Practice Address - Street 1:1500 E HILLSBORO BLVD
Practice Address - Street 2:SUITE #208
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4355
Practice Address - Country:US
Practice Address - Phone:954-420-0551
Practice Address - Fax:954-420-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11961122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty