Provider Demographics
NPI:1255522124
Name:SUAREZ, HENRY (DDS)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 SOUTHGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-1660
Mailing Address - Country:US
Mailing Address - Phone:954-724-8949
Mailing Address - Fax:954-724-1185
Practice Address - Street 1:7110 SOUTHGATE BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068-1660
Practice Address - Country:US
Practice Address - Phone:954-724-8949
Practice Address - Fax:954-724-1185
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN178321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN17832OtherFLORIDA LICENSE NUMBER