Healthcare Provider Details

I. General information

NPI: 1306322052
Provider Name (Legal Business Name): SLINGBAUM & ZUPNIK ORTHODONTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 NW 5TH ST
PLANTATION FL
33317-1606
US

IV. Provider business mailing address

7400 NW 5TH ST
PLANTATION FL
33317-1606
US

V. Phone/Fax

Practice location:
  • Phone: 954-797-4171
  • Fax:
Mailing address:
  • Phone: 954-797-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JAMIE ZUPNIK
Title or Position: OWNER
Credential: D.M.D., MS
Phone: 954-797-4171