Healthcare Provider Details

I. General information

NPI: 1740452325
Provider Name (Legal Business Name): EAST BOCA DENTAL IMPLANTS&PROSTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 13TH ST SUITE 300
BOCA RATON FL
33486-2335
US

IV. Provider business mailing address

900 NW 13TH ST SUITE 300
BOCA RATON FL
33486
US

V. Phone/Fax

Practice location:
  • Phone: 561-395-3190
  • Fax: 561-385-3199
Mailing address:
  • Phone: 561-395-3190
  • Fax: 561-385-3199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN17454
License Number StateFL

VIII. Authorized Official

Name: DR. CAROLINA STEIER
Title or Position: C.E.O
Credential: D.M.D
Phone: 561-395-3190