Provider Demographics
NPI:1790830164
Name:AROCHA, MAX (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:AROCHA
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 1:10031 PINES BLVD
Mailing Address - Street 2:SUITE W-101
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6179
Mailing Address - Country:US
Mailing Address - Phone:954-432-7771
Mailing Address - Fax:954-437-5808
Practice Address - Street 1:10031 PINES BLVD
Practice Address - Street 2:SUITE W-101
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6179
Practice Address - Country:US
Practice Address - Phone:954-432-7771
Practice Address - Fax:954-437-5808
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 166561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice