Healthcare Provider Details

I. General information

NPI: 1679123012
Provider Name (Legal Business Name): SWEET TOOTH PEDIATRIC DENTISTRY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 WESTON RD STE 300
WESTON FL
33326-1912
US

IV. Provider business mailing address

1040 WESTON RD STE 300
WESTON FL
33326-1912
US

V. Phone/Fax

Practice location:
  • Phone: 954-384-8888
  • Fax: 954-384-9434
Mailing address:
  • Phone: 954-384-8888
  • Fax: 954-384-9434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ERIN S ARROYO
Title or Position: OWNER/ DENTIST
Credential: DMD
Phone: 925-216-5652