Healthcare Provider Details

I. General information

NPI: 1063454601
Provider Name (Legal Business Name): ANTHONY G SCLAR D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 RED RD SUITE 101
SOUTH MIAMI FL
33143-5428
US

IV. Provider business mailing address

7600 RED RD SUITE 101
SOUTH MIAMI FL
33143-5428
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-5297
  • Fax: 305-667-3503
Mailing address:
  • Phone: 305-661-5297
  • Fax: 305-667-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN0010151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: