Provider Demographics
NPI:1205241916
Name:DIXON AND DIXON
Entity type:Organization
Organization Name:DIXON AND DIXON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-523-8788
Mailing Address - Street 1:1620 SE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2528
Mailing Address - Country:US
Mailing Address - Phone:954-523-8788
Mailing Address - Fax:
Practice Address - Street 1:1620 SE 4TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2528
Practice Address - Country:US
Practice Address - Phone:954-523-8788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3742261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental