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General NPI Number Information
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NPI Number | 1093950768
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Entity Type | Individual
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Provider Name | AIDA LUPU DMD
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Gender | Female
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 2100 E HALLANDALE BEACH BLVD SUITE 304
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3765
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Country | US
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Telephone | 954-471-7569
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Fax | 954-457-9141
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Provider Business Mailing Address
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Address Line | 14035 S CYPRESS COVE CIR
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City | DAVIE
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State | FL
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Zip | 33325-6743
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Country | US
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Telephone | 954-471-7569
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN18490
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License Number State | FL
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