Provider Demographics
NPI:1568722932
Name:DEERFIELD BEACH PARTNERS IN DENTISTRY, PA
Entity Type:Organization
Organization Name:DEERFIELD BEACH PARTNERS IN DENTISTRY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:ORTLIEB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-427-7513
Mailing Address - Street 1:313 SE 15TH TER STE A
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4472
Mailing Address - Country:US
Mailing Address - Phone:954-427-7513
Mailing Address - Fax:954-427-7676
Practice Address - Street 1:313 SE 15TH TER STE A
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4472
Practice Address - Country:US
Practice Address - Phone:954-427-7513
Practice Address - Fax:954-427-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-20
Last Update Date:2012-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN137021223G0001X
FLDN170121223G0001X
FLDN91301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty