Healthcare Provider Details

I. General information

NPI: 1558831990
Provider Name (Legal Business Name): SHAPIRO FAMILY DENTISTRY OF BOYNTON BEACH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9868 S STATE ROAD 7 STE 200
BOYNTON BEACH FL
33472-4473
US

IV. Provider business mailing address

2247 PALM BEACH LAKES BLVD STE 105
WEST PALM BEACH FL
33409-3408
US

V. Phone/Fax

Practice location:
  • Phone: 561-254-2868
  • Fax: 561-998-0901
Mailing address:
  • Phone: 561-254-2868
  • Fax: 561-998-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DARI SHAPIRO
Title or Position: PRESIDENT
Credential: DDS
Phone: 561-254-2868