Healthcare Provider Details

I. General information

NPI: 1831599331
Provider Name (Legal Business Name): EDUARDO ANDRES CRUZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 N FEDERAL HWY
LIGHTHOUSE POINT FL
33064-6738
US

IV. Provider business mailing address

3140 N FEDERAL HWY
LIGHTHOUSE POINT FL
33064-6738
US

V. Phone/Fax

Practice location:
  • Phone: 954-532-1259
  • Fax: 954-532-1273
Mailing address:
  • Phone: 954-532-1259
  • Fax: 954-532-1273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDL12326
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN22500
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: