MEDICARE: ALENCAR DENTAL LLC

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

General Provider Information

NPI Number	:	1356110142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALENCAR DENTAL LLC

Provider Business Mailing Address
First Line	:	901 SE 8TH AVE
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-5611
Country	:	US
Telephone Number	:	954-426-2298
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 SE 8TH AVE
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-5611
Country	:	US
Telephone Number	:	954-426-2298
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. SIMONE ALENCAR
Credential	:	DMD
Telephone Number	:	954-426-2298

Provider Enumeration Date	:	12/21/2023
Last Update Date	:	12/21/2023

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Directions to “ALENCAR DENTAL LLC ” Practice Location

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