Provider Demographics
NPI:1760644306
Name:SHAPIRO FAMILY DENTISTRY
Entity Type:Organization
Organization Name:SHAPIRO FAMILY DENTISTRY
Other - Org Name:DENTAL MAX USA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARI
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-684-2282
Mailing Address - Street 1:2247 PALM BEACH LAKES BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3408
Mailing Address - Country:US
Mailing Address - Phone:561-684-2282
Mailing Address - Fax:561-616-2556
Practice Address - Street 1:2247 PALM BEACH LAKES BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3408
Practice Address - Country:US
Practice Address - Phone:561-684-2282
Practice Address - Fax:561-616-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 15327 FL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty