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NPI Code Detail

MEDICARE: FORT LAUDERDALE GALLERIA DENTAL IMPLANT AND ORTHODONTIC CENTER

MEDICARE: FORT LAUDERDALE GALLERIA DENTAL IMPLANT AND ORTHODONTIC CENTER
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1669964276
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORT LAUDERDALE GALLERIA DENTAL IMPLANT AND ORTHODONTIC CENTER
Provider Business Mailing Address
First Line : 2300 NE 9TH ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-3579
Country : US
Telephone Number : 954-566-1281
Fax Number :
Provider Business Practice Location Address
First Line : 2300 NE 9TH ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-3579
Country : US
Telephone Number : 954-566-1281
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DENNIS SEVEL
Credential : DDS
Telephone Number : 954-566-1281
Provider Enumeration Date : 05/31/2018
Last Update Date : 05/31/2018

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Directions to “FORT LAUDERDALE GALLERIA DENTAL IMPLANT AND ORTHODONTIC CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.