Healthcare Provider Details

I. General information

NPI: 1174638191
Provider Name (Legal Business Name): HOWARD L. PASEKOFF D.M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 12/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3185 ST JAMES DRIVE
BOCA RATON FL
33434
US

IV. Provider business mailing address

3185 ST. JAMES DRIVE
BOCA RATON FL
33434
US

V. Phone/Fax

Practice location:
  • Phone: 561-487-0595
  • Fax: 561-483-6410
Mailing address:
  • Phone: 561-487-0595
  • Fax: 561-483-6410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number6099
License Number StateFL

VIII. Authorized Official

Name: DR. HOWARD L. PASEKOFF
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 561-487-0595