Provider Demographics
NPI:1891455994
Name:DDSC LLC
Entity Type:Organization
Organization Name:DDSC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CERRUTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-885-9560
Mailing Address - Street 1:9449 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8561
Mailing Address - Country:US
Mailing Address - Phone:954-885-9560
Mailing Address - Fax:
Practice Address - Street 1:9449 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8561
Practice Address - Country:US
Practice Address - Phone:954-885-9560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty