MEDICARE: YISROLE NOSKOW DMD PALM CITY PA

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1487320024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YISROLE NOSKOW DMD PALM CITY PA

Provider Business Mailing Address
First Line	:	990 SE 7TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-9506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1151 SW 30TH ST STE C
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-2985
Country	:	US
Telephone Number	:	772-409-6772
Fax Number	:

Authorized Official
Title or Position	:	DR
Name	:	DR. YISROEL NOSKOW
Credential	:	DMD
Telephone Number	:	772-409-6772

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	08/23/2021

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