Provider Demographics
NPI:1023530284
Name:PALM BEACH DENTAL STUDIO, PLLC
Entity type:Organization
Organization Name:PALM BEACH DENTAL STUDIO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOVETERE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-488-0770
Mailing Address - Street 1:9070 KIMBERLY BLVD STE 60
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9070 KIMBERLY BLVD STE 60
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2861
Practice Address - Country:US
Practice Address - Phone:561-488-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental