Healthcare Provider Details

I. General information

NPI: 1548371941
Provider Name (Legal Business Name): STEPHEN RIMER BDS, PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 MEADOWS RD SUITE 121
BOCA RATON FL
33486-2347
US

IV. Provider business mailing address

825 MEADOWS RD SUITE 121
BOCA RATON FL
33486-2347
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-3170
  • Fax: 561-338-6231
Mailing address:
  • Phone: 561-368-3170
  • Fax: 561-338-6231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN8602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: