Provider Demographics
NPI:1629245907
Name:PODBIELSKI, DAVID P (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:PODBIELSKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5414
Mailing Address - Country:US
Mailing Address - Phone:561-842-3331
Mailing Address - Fax:561-844-0417
Practice Address - Street 1:429 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5414
Practice Address - Country:US
Practice Address - Phone:561-842-3331
Practice Address - Fax:561-844-0417
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12386122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist