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General NPI Number Information
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NPI Number | 1104907716
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Entity Type | Organization
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Legal Business Name | ANDREA TRUJILLO DMD PA
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 9873 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-433-5231
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Fax | 954-433-9477
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Provider Business Mailing Address
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Address Line | 9873 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-433-5231
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Fax | 954-433-9477
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Authorized Official
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Title or Position | OWNER/GENERAL DENTIST
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Name | DR. ANDREA TRUJILLO
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Credential | DMD
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Telephone | 954-433-5231
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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 |
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License Number State |
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