Provider Demographics
NPI:1619106580
Name:WESTON FAMILY DENTAL CENTER, INC
Entity Type:Organization
Organization Name:WESTON FAMILY DENTAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:DIFILIPPO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-385-9240
Mailing Address - Street 1:1350 SW 160TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1908
Mailing Address - Country:US
Mailing Address - Phone:954-385-9240
Mailing Address - Fax:954-385-9258
Practice Address - Street 1:1350 SW 160TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1908
Practice Address - Country:US
Practice Address - Phone:954-385-9240
Practice Address - Fax:954-385-9258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11695122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty