| NPI | 1104844596 |
|---|---|
| Doing Business As | DENTAL SPECIALTY CENTER OF SUNRISE |
| Entity Type | Organization |
| Authorized Contact | MARC COWAN President 954-474-9660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: FL 7432) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: FL 9476) |
| 1223P0300X Dentist Periodontics (Licence: FL 9694) | |
| 1223P0300X Dentist Periodontics (Licence: FL 17373) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: FL 9191) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: FL 9783) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: FL 16125) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-08-22 |