Healthcare Provider Details

I. General information

NPI: 1477720225
Provider Name (Legal Business Name): CARE DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 BOYNTON BEACH BLVD SUITE 200
BOYNTON BEACH FL
33437-3588
US

IV. Provider business mailing address

6080 BOYNTON BEACH BLVD SUITE 200
BOYNTON BEACH FL
33437-3588
US

V. Phone/Fax

Practice location:
  • Phone: 561-364-2273
  • Fax: 561-364-2272
Mailing address:
  • Phone: 561-364-2273
  • Fax: 561-364-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL A EISENBAND
Title or Position: PRESIDENT
Credential: D.M.D
Phone: 561-364-2273