Provider Demographics
NPI:1912151903
Name:ARIAS, SERGIO R (DDS, MS)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:R
Last Name:ARIAS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 E LAS OLAS BLVD STE 3W
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1578
Mailing Address - Country:US
Mailing Address - Phone:954-467-0303
Mailing Address - Fax:
Practice Address - Street 1:2300 E LAS OLAS BLVD STE 3W
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1578
Practice Address - Country:US
Practice Address - Phone:954-467-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN185551223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics