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General NPI Number Information
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NPI Number | 1235427121
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Entity Type | Organization
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Legal Business Name | DAVID EUGENE, D.D.S, P.L.L.C
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 2447 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313
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Country | US
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Telephone | 954-733-9971
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Fax | 954-733-5521
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Provider Business Mailing Address
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Address Line | 2447 N STATE ROAD 7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-3723
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Country | US
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Telephone | 954-733-9971
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Fax | 954-733-5521
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DELMIS GONZALEZ
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Credential |
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Telephone | 954-733-9971
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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 | DN18594
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License Number State | FL
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