Provider Demographics
NPI:1639541006
Name:ARFA DENT, INC
Entity Type:Organization
Organization Name:ARFA DENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AREVALO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-391-6066
Mailing Address - Street 1:7301 W PALMETTO PARK RD STE 203B
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3456
Mailing Address - Country:US
Mailing Address - Phone:561-391-6066
Mailing Address - Fax:561-393-7361
Practice Address - Street 1:7301 W PALMETTO PARK RD STE 203B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3456
Practice Address - Country:US
Practice Address - Phone:561-391-6066
Practice Address - Fax:561-393-7361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN194481223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3843100Medicaid