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General NPI Number Information
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NPI Number | 1215739255
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Entity Type | Organization
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Legal Business Name | EAST BOYNTON DENTISTRY LLC
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 207 SE 23RD AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7653
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Country | US
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Telephone | 561-734-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 3003 W YAMATO RD STE C5
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City | BOCA RATON
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State | FL
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Zip | 33434-5337
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Country | US
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Telephone | 561-998-0727
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NAVED FATMI
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Credential | DMD
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Telephone | 786-457-3690
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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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