Provider Demographics
NPI:1356935050
Name:SOUTH FLORIDA DENTAL CENTER
Entity type:Organization
Organization Name:SOUTH FLORIDA DENTAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-217-1731
Mailing Address - Street 1:7522 WILES RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2056
Mailing Address - Country:US
Mailing Address - Phone:954-755-7971
Mailing Address - Fax:954-755-7994
Practice Address - Street 1:7522 WILES RD STE 104
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2056
Practice Address - Country:US
Practice Address - Phone:954-755-7971
Practice Address - Fax:954-755-7994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental