Provider Demographics
NPI:1851309827
Name:DR MICHAEL A CITRON DMD PA
Entity Type:Organization
Organization Name:DR MICHAEL A CITRON DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CITRON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-697-2220
Mailing Address - Street 1:771 VILLAGE BLVD
Mailing Address - Street 2:SUITE #203
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:561-697-2220
Mailing Address - Fax:561-697-2221
Practice Address - Street 1:771 VILLAGE BLVD
Practice Address - Street 2:SUITE #203
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:561-697-2220
Practice Address - Fax:561-697-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty