Provider Demographics
NPI:1629278809
Name:DANIELA A TUDORAN,DDS AND TIMOTHY M. VINER, DDS, PA
Entity Type:Organization
Organization Name:DANIELA A TUDORAN,DDS AND TIMOTHY M. VINER, DDS, PA
Other - Org Name:LASER DENTISTRY OF SOUTH FLORIDA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VINER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-367-9922
Mailing Address - Street 1:240 W PALMETTO PARK RD
Mailing Address - Street 2:STE 100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3761
Mailing Address - Country:US
Mailing Address - Phone:561-367-9922
Mailing Address - Fax:
Practice Address - Street 1:240 W PALMETTO PARK RD
Practice Address - Street 2:STE 100
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3761
Practice Address - Country:US
Practice Address - Phone:561-367-9922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN128071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty