Provider Demographics
NPI:1679634232
Name:ALVAREZ, JORGE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:A
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10395 GENTLEWOOD FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-4863
Mailing Address - Country:US
Mailing Address - Phone:561-792-7766
Mailing Address - Fax:561-784-9457
Practice Address - Street 1:8993 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5144
Practice Address - Country:US
Practice Address - Phone:561-792-7766
Practice Address - Fax:561-784-9457
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN153631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice