Healthcare Provider Details

I. General information

NPI: 1609820141
Provider Name (Legal Business Name): HOWARD L PASEKOFF D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 11/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3185 SAINT JAMES DR
BOCA RATON FL
33434-3372
US

IV. Provider business mailing address

3185 SAINT JAMES DR
BOCA RATON FL
33434-3372
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 NumberFL6099
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: