Provider Demographics
NPI:1841228434
Name:DANIEL E GEWARTOWSKI DDS PA
Entity Type:Organization
Organization Name:DANIEL E GEWARTOWSKI DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GEWARTOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-241-7272
Mailing Address - Street 1:2600 N MILITARY TRL
Mailing Address - Street 2:STE 348
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6312
Mailing Address - Country:US
Mailing Address - Phone:561-241-7272
Mailing Address - Fax:561-241-4986
Practice Address - Street 1:2600 N MILITARY TRL
Practice Address - Street 2:STE 348
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6312
Practice Address - Country:US
Practice Address - Phone:561-241-7272
Practice Address - Fax:561-241-4986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5713261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental