Provider Demographics
NPI:1952674566
Name:ADVANCED DENTISTRY OF PLANTATION
Entity Type:Organization
Organization Name:ADVANCED DENTISTRY OF PLANTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-583-1152
Mailing Address - Street 1:301 N.W. 84TH AVE
Mailing Address - Street 2:SUIT 300
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1807
Mailing Address - Country:US
Mailing Address - Phone:954-583-1152
Mailing Address - Fax:954-583-8977
Practice Address - Street 1:301 N.W. 84TH AVE
Practice Address - Street 2:SUIT 300
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1807
Practice Address - Country:US
Practice Address - Phone:954-583-1152
Practice Address - Fax:954-583-8977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL7155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty