Provider Demographics
NPI:1295949543
Name:SUNSET LAKES DENTAL & ORTHODONTIC CENTER
Entity type:Organization
Organization Name:SUNSET LAKES DENTAL & ORTHODONTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:SOLOMON
Authorized Official - Last Name:SEVEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-433-4300
Mailing Address - Street 1:18431 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5802
Mailing Address - Country:US
Mailing Address - Phone:954-433-4300
Mailing Address - Fax:954-433-0312
Practice Address - Street 1:18431 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5802
Practice Address - Country:US
Practice Address - Phone:954-433-4300
Practice Address - Fax:954-433-0312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN116951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty