Provider Demographics
NPI:1841645249
Name:SETH D. POMERANTZ, DMD, PA
Entity type:Organization
Organization Name:SETH D. POMERANTZ, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:POMERANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-726-4511
Mailing Address - Street 1:8201B N PINE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1500
Mailing Address - Country:US
Mailing Address - Phone:954-726-4511
Mailing Address - Fax:954-726-5248
Practice Address - Street 1:8201B N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1500
Practice Address - Country:US
Practice Address - Phone:954-726-4511
Practice Address - Fax:954-726-5248
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SETH D. POMERANTZ, DMD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174591223P0300X
FL112641223S0112X
FL14357122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty