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General NPI Number Information
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NPI Number | 1063937878
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Entity Type | Organization
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Legal Business Name | BOCA DENTAL ARTS PA
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 21073 POWERLINE RD STE 65
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City | BOCA RATON
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State | FL
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Zip | 33433-2306
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Country | US
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Telephone | 561-235-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 20968 CERTOSA TER
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City | BOCA RATON
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State | FL
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Zip | 33433-1638
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Country | US
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Telephone | 239-248-7443
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Fax |
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. AXEL E MCGUFFIE
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Credential | DMD
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Telephone | 561-235-5424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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