MEDICARE: DR. PANAYOTIS PAPATZIMAS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	051131-1	NY

General Provider Information

NPI Number	:	1245236546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PANAYOTIS PAPATZIMAS DDS

Provider Business Mailing Address
First Line	:	3200 S UNIVERSITY DR
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-2018
Country	:	US
Telephone Number	:	954-568-7709
Fax Number	:	954-568-7749

Provider Business Practice Location Address
First Line	:	830 E OAKLAND PARK BLVD
Second Line	:	SUITE # 103
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-2761
Country	:	US
Telephone Number	:	954-568-7709
Fax Number	:	954-568-7749

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/26/2008

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